INTRODUCTION: Bacterial meningitis is among the febrile, lethal and life-threatening diseases in neonates and children under 10 years, especially in low-income countries. The study determined the prevalence and outcome of the disease among neonates, infants and children less than 10 years admitted at St. Francis Referral Hospital.METHODS: A hospital-based study was carried out among 856 children less than ten years, with or without fever for 10 months; clinical and laboratory records were reviewed. Data analysis was done using Chi-square and independent t-test to establish the odds ratio of acquiring the disease.RESULTS: Out of 856 records of children with fever 656 had signs of meningitis, 71 children underwent lumbar puncture where 49.3% and 50.7% were female and male respectively; Aged 0 - 2 years (47.9%), 3 – 5 years (19.7%) and 6 – 10 years (32.4%). 62% of the patients had neurological signs, 56.3% had >45mmol/dl CSF (cerebrospinal fluid) glucose concentration and 85.9% had >50mg/dl of the CSF protein concentration. Escherichia coli, Klebsiella pneumoniae, Haemophilus influenzae and Neisseria meningitides were mostly isolated from the CSF samples at the hospital. Location (OR) = 3.1; p = 0.0017), parity of the mother (OR = 3.8; p = 0.008), Neurological signs (OR = 4.5; p = 0.001) and elevated CSF protein (OR = 4.5; p = 0.001) were the factors associated with bacterial meningitis infection among children.CONCLUSION: Meningitis is a life-threatening infection in children under 10 years. Thus, microbial isolation should be established in most hospitals to improve early case identification and reporting at health facilities and the national level.