Objective To investigate the clinical features of neonatal purulent meningitis and provide guidance for clinical diagnosis and treatment. Methods The clinical features of 76 patients diagnosed neonatal purulent meningitis from Chengdu Central Hospital of Women and Children between January 2011 and December 2015 were retrospectively analyzed. The patients, according to gestational age, were divided into full term group and preterm group. Results The main clinical manifestations of full term group were fever (chi square=6.94, P=0.045), convulsions (chi square=8.51, P=0.026) and abnormal muscle tone (chi square=9.63, P=0.021). The main clinical manifestations of preterm group were apnea outperform (chi square=10.57, P=0.014). The main bacteria of CSF cultures are Escherichia Coli and group B streptococcal. The treatment time of full term group and preterm group were 25±4 day and 31±9 day. According to Head MRI, 289% of children with different degree of brain injury was found. The premature children shown cerebral hemorrhage (chi square=8.72, P=0.013), cerebral white matter abnormalities signal change (chi square=10.24, P=0.01) and abnormal auditory evoked potential (chi square=9.42, P=0.02). Conclusion Clinical manifestations of neonatal purulent meningitis are not typical. The clinicians should be alert to the clinical children with unknown reasons or unexplained fever and apnea. E. coli, group B streptococcal infection should be on high alert. The neonatal purulent meningitis cure need long time, and maybe have different level sequelae, brain dysfunction and hearing loss occurs in premature children more possibility than full term children.