Objectives: To explore the clinical characteristics and analyze the pathogens of bacterial meningitis in children. Methods: Bacterial meningitis cases occurring from January 2010 through December 2014 at Beijing Children's Hospital were reviewed retrospectively. The records of all patients, including data on clinical features and laboratory information, were obtained and analyzed. Results: In total, the cases of 507 pediatric patients seen over a 5-year period were analyzed; 220 of these cases were etiologically confirmed. These patients were classified into four age groups: 29 days to 1 year (n = 373, 73.6%), 1-3 years (n = 61, 12.0%), 3-6 years (n = 41, 8.1%), and >6 years (n = 32, 6.3%). The main pathogens identified in this study were Streptococcus pneumoniae (n = 73, 33.2%), Escherichia coli (n = 24, 10.9%), Enterococcus (n = 22, 10.0%), and group B Streptococcus (n = 18, 8.2%). All Gram-positive bacteria were sensitive to vancomycin and linezolid. All Gram-negative bacteria were sensitive to meropenem. The total non-susceptibility rate of S. pneumoniae to penicillin was 47.6% (20/42). The resistance rates to ceftriaxone, cefepime, and ceftazidime were 75% (9/12), 55.6% (5/9), and 40% (4/10), respectively. Conclusions: The main pathogen of bacterial meningitis in this study was S. pneumoniae. The antibiotic resistance rates among children with bacterial meningitis are of serious concern. (C) 2016 The Author(s). Published by Elsevier Ltd on behalf of International Society for Infectious Diseases.