Objective Bacterial meningitis is a major cause of mortality and morbidity in neonates . Large-scale epidemiology data on neonatal meningitis are scarce in China .This study aimed to investigate the incidence, etiology, and outcomes of neonatal meningitis in 13 hospitals of Northern China.Method We performed a one year prospective cohort study in 13 neonatal intensive care units from four provinces (Hebei, Shanxi, Henan, Shandong) in Northern China.The following information of neonatal bacterial meningitis was collected: blood and cerebrospinal fluid ( CSF ) culture findings , demographic characteristics, hematological and CSF parameters , and outcome.Result A total of 236 neonates were included in the study, male 149 (63.1%).The mean gestational age and birth weight were (38.0 ±2.9) weeks and ( 3082 ±746 ) g, respectively.Only 71 ( 30.9%) neonates had a positive blood culture . Positive CSF culture results were found in 30.5% ( 65/213 ) of the patients.Among the early-onset meningitis, Staphylococcus aureus ( 6 cases, 35.3%), E.coli ( 2 cases, 11.8%) were the main pathogens.Among the late onset meningitis, E.coli was the main pathogen (18 cases, 37.5%), followed by Staphylococcus haemolyticus ( 6 cases, 12.5%) .The median ( interquartile range ) white blood cell count in CSF was 330/mm3(838), with a range of 0~92512/mm3.67 (28.4%) patients had white blood cell count>1000/mm3 in CSF.The overall case mortality was 6.8% ( 16/236 ) .The case mortality was 33% for K.pneumoniae , and 25% for E.coli meningitis , but 0 for Gram-positive meningitis.E.coli was responsible for approximately one third of all deaths caused by meningitis .Conclusion This study provides essential information regarding the etiology , characteristics , and outcome of neonatal bacterial meningitis in Northern China.E.coli was the most common Gram-negative organism causing late onset meningitis with high case fatality.