Objective To investigate the clinical characteristics of childhood purulent meningitis (PM) and the risk factors for its adverse outcome. Methods One hundred and nine children with PM were retrospective analyzed, who were admitted to pediatric department in Xijing Hospital of the Fourth Military Medical University from Ja-nuary 2008 to July 2016.They were divided into 5 age groups, the clinical features were compared among the different age groups.According to Glasgow prognostic score, all cases were then divided into 2 groups, the favorable outcome group and the adverse outcome group.All factors including normal information, disease history, clinical manifestations and laboratory examinations were compared between 2 groups. Results There were 72.5% (79/109 cases) of the patients younger than 3 years old.PM was prone to spring and winter, and most children with PM had preceding infection.The major clinical manifestations of PM were fever, convulsions and intracranial hypertension.The clinical manifestations of PM were different in different age groups, and convulsions were more commonly seen in less than 3 years old children, while headache, vomiting and meningeal stimulation had higher proportion in more than 3 years old children.The single factor analysis showed that there were repeated convulsions after admission (≥3 times), the cerebrospinal fluid (CSF) glucose(≤1.5 mmol/L), CSF protein(≥1 g/L), CSF/blood glucose ratio and complications were significantly different between 2 groups(all P 500×106 /L, blood and CSF cultivate positive rate, co-infection, brain CT/MRI abnormality, electroencephalogram abnormality, treatment and duration of seizure more than 5 minutes were not significantly different(all P>0.05). Multivariate analysis showed that there were repeated convulsions after admission (≥3 times) (OR=27.84, P=0.048), CSF protein(≥1 g/L)(OR=28.44, P=0.027)and low CSF/blood glucose ratio (OR=22.15, P=0.041)were independent risk factors for poor prognosis of PM. Conclusion PM happens mostly in infantile period, with different clinical manifestations at different ages.The independent risk factors for poor prognosis were repeated convulsions after admission (≥3 times), CSF protein(≥1 g/L)and low CSF/ blood glucose ratio.It indicates that if the high risk factors could be identified early, and then intervened immediately and followed up timely, it will be beneficial to improve the long-term prognosis. Key words: Purulent meningitis; Clinical feature; Adverse outcome; Risk factor