Abstract: Objective　To explore the clinical characteristics of purulent meningitis caused by different pathogens in neonates. Methods Clinical data of 172 cases of neonatal purulent meningitis from January 1, 2011 to December 31, 2012 were retrospectively analyzed. Results Cerebrospinal fluid (CSF) appeared turbid and purulent in 54 cases (31.4%). The CSF cultures showed positive in 70 cases (40.7%), and Escherichia coli (E. coli) and staphylococcus were common. Thirty-one patients had complications (18.0%), among whom, 14 patients (8.1%) were complicated by hydrocephalus. Among E. coli meningitis group, other pathogens group and unknown pathogens group, there were significant differences in the rate of abnormal CSF appearance, CSF white blood cell counts, the rate of CSF white blood cell counts greater than 500×106/L, the levels of sugar and protein in CSF, duration of fever, the time of CSF return to normal, length of hospital stay and cost, complication and case-fatality rate (all P<0.05). Conclusions When CSF appears turbid and purulent, especially when CSF white blood cell counts are greater than 500×106/L, E. coli infection should be considered. The purulent meningitis caused by E. coli has high occurrence rates of complication and case-fatality and poor prognosis.