Meningitis remains a significant health problem for the older adult population. Although the overall incidence of this disease has decreased in the United States, the incidence of meningitis in the elderly population is increasing. Additionally, the recognition of meningitis in the older adult may be more difficult because the usual symptoms and signs are neither as specific nor as sensitive as they are in a younger population. Newer antibiotics have provided better therapeutic approaches to some of the organisms responsible for this disease, and newer methods of therapy beyond antibiotics hold the promise of altering the unacceptably high morbidity and mortality.