A retrospective study in patients over 65 years old with acute bacterial meningitis admitted to the internal medicine department of the "Hospital Provincial de Zamora" over the last 25 years, is presented. 43 cases (26.87%) over 65 years old were found, out of 160 cases admitted with ABM during this period. This high prevalence is partially explained because of the large elderly population in this area. The frequent atypical clinical features than can result in the diagnosis being confused with neurological pathology such as CVA (which is common at this age) is noteworthy. The most frequent etiology was meningococos (41.86%), followed by pneumococos (4.6%) and E. Coli (4.6%). We highlight the good prognosis of ABM in the elderly, early diagnosis and the right therapy necessary to achieve it.