BACKGROUND; Meningitis is among the major causes of morbidity and mortality in infants and children below the age of five. Globally Bacterial meningitis is the severe form of meningitis causing approximately 1.2million cases worldwide annually, the other forms includes fungal and viral meningitis. Its incidence in children is said to be 25 per 100000 children in Africa. In children, the diagnosis of acute bacterial meningitis (ABM) is difficult and challenging because of non specific signs and symptoms so a high degree of suspicious is required to make a diagnosis of meningitis in children. Without immediate proper management, meningitis may lead to death outcome or severe neurological sequelae such as seizure disorders, hearing loss and hydrocephalus among survivors. OBJECTIVES; to determine the prevalence, clinical presentations and outcomes of bacterial meningitis among children admitted at KCMC pediatric unit from January 2014- December2015. METHODS; this was a hospital based retrospective cross sectional study carried out in children diagnosed with Acute Bacterial Meningitis (clinically or by laboratory investigations) and admitted at pediatric department of KCMC from January 2014 to December 2015. All children aged 2 months-13 years who met the eligibility criteria were included in the study. The study involved record review of all reported cases of meningitis through the use of patient’s files from KCMC medical records department. Data processing and analysis was done using SPSS version 20. RESULTS: During the study period a total of 3797 patients were admitted at pediatric ward of KCMC, and 163 (4.3%) were diagnosed with Acute Bacterial Meningitis. Only 108 were eligible for the study, of which only 43 undergone lumbar puncture and analysis of their CSF was done, whereby only 3 (6.9%) were found to be culture positive for microorganisms. The common clinical presentations reported at the time of admission were fever 96 (88.9%), convulsion 77(71.3%) and vomiting 38 (35.2%). Of all the participants, 74 (68.5%) recovered completely, 24 (22.2%) died and 10 (9%) recovered with complications. Speech problem 3(2.7%) was more reported in many who recovered with complications. x CONCLUSION; Despite the low prevalence of meningitis found in this study (4.3% as an overall prevalence and 6.9% by culture confirmation), still a high case-fatality rate of 22.2% was reported. Majority of those who died 19 (79.1%), were reported to die within 48 hours of admission, this indicates that an early diagnosis and proper treatment and management of bacterial meningitis are required so as to decrease both its morbidity and mortality. RECOMMENDATION; More studies about meningitis in children should be done in our setting so as to explore more about this disease as few studies about this disease especially on its case-fatality rates and outcomes of the patients have been done.