In this report, primary Clostridium perfringens meningitis, a rare condition, is described in a 62-year-old man who developed fatal clostridial meningitis following surgical evacuation of a subdural hematoma. This is the third case report of clostridial meningitis as a complication of craniotomy. Clostridial infection should be considered in any patient with meningitis with a history of surgical intervention, or head injury, even if only slight.