<p>We recorded 646 patients with acute bacterial meningitis including 330 before and 316 after the introduction of the conjugate vaccine A in Mali. Children under the age of one were the most affected. S pneumoniae was the most responsible 186 (56%) of acute bacterial meningitis before the introduction against 176 (56%) after the introduction of the conjugate vaccine in children under one year old. The introduction of the conjugate vaccine A has led to the disappearance of acute bacterial meningitis due to meningococcal A. However, other strains of meningococci Neisseria meningitidis C, X and W135 remain the most responsible for acute bacterial meningitis in children over 5 years. The age groups of less than one year (p&lt;0.001), 5 – 14 years, 14 – 29 years (p&lt;0.001), people living in rural areas (p&lt;0.001) and the cloudy aspect of the CSF (p&lt;0.001) were independently associated with acute bacterial meningitis in Mali</p>