OBJECTIVE: To describe the epidemiologic features of meningitis in Al-Ain Medical District, United Arab Emirates from January 2000 through June 2005. METHODS: A retrospective review of clinical records and notification forms for cases of meningitis reported to the Department of Preventive Medicine, Al-Ain. Data collected and compiled included demographic features, causative microbiologic agents, and annual incidence rates of meningitis, by etiology. RESULTS: Ninety-two cases of meningitis were reported during the study period; 53% were bacterial and 37% were viral in origin. Neisseria meningitidis was the leading bacterial pathogen (35%) followed by Streptococcus pneumoniae (16%). Ten percent of clinically diagnosed cases of meningitis had no causative microorganism recovered, and in 33% of patients with presumed pyogenic meningitis no specific bacterial pathogen could be identified. The peak occurrence of meningitis was in young children less than one year old. Most cases of meningococcal meningitis were seen among prison inmates and laborers, while viral meningitis occurred mainly in children and young adults attending school. The incidence rate of meningitis in Al-Ain ranged between 2.2/100,000 population in 2000 and 1/100,000 in 2005, with an overall downward trend by year. The incidence of Haemophilus influenzae type b decreased significantly after implementation of the national immunization program in 1999. CONCLUSIONS: Improved methods of bacterial detection including isolate serotyping must be made available in order to further reduce mortality and morbidity from meningitis.