OBJECTIVES: A systematic review was used to assess economic costs of bacterial meningitis. METHODS: PubMed, Scopus and NHS-EED were searched to identify eligible papers. Economic evaluations that cost bacterial meningitis cases were selected. Reported direct and indirect costs were converted to 2012 international dollars and reported in ranges (minimum and maximum). RESULTS: We identified 621 non-duplicated articles. 118 papers were selected for full-text revision. 25 studies accomplished the inclusion criteria and were carried out in 27 countries. Most studies were undertaken in high-income countries (n=17). Only two studies took place in low income countries. Minimum and maximum laboratory mean costs were found in Burkina Faso (I$ 6) and Chile (I$ 1,604), respectively. Regarding to medication costs, the mean minimal cost was I$ 90 (Kenia) and the maximal I$ 1,284 (Rusia). Chile recorded the higher hospital cost of stay (I$ 9,144) and Burkina Faso the lower (I$ 107). Out-of-pocket health expenditures were estimated only in one study (Senegal, I$ 2,444). Among high income countries studies, the higher and lower total costs were reported in the United States and Suiza (I$151,449 – I$3,804). CONCLUSIONS: A large cost variability was found in the included studies. High-income countries economic costs were superior versus low-income countries costs. Even though Subsaharian countries has a high bacterial meningitis incidence, only three studies were undertaken in this area.