Introduction: Meningoencephalitis (ME) represents a serious neuroinfectious emergency, particularly in resource-limited countries where etiological diagnosis is often delayed or impossible. In sub-Saharan Africa, specific data in resuscitation are few. The objective was to describe the clinical profile, diagnostic and therapeutic challenges of ME in intensive care at the University Hospital of Angré. Methods: We conducted a 24-month retrospective observational study on patients admitted for ME, defined according to recognized clinical criteria, and who had received a lumbar puncture. Clinical data and standard analyses of the CSF were collected. The data was analyzed in a descriptive and univariate way with Epi Info TM. Results: The cohort included young patients (median age 13 years), with high severity at admission and significant mortality (70%). The lumbar puncture, performed in 63% of cases, showed an inflammatory CSF, but without etiological agent identification, notably due to the lack of advanced molecular tools. Co-infections and comorbidities, including HIV, complicated management. Conclusion: This study highlights the major diagnostic limitations and a high mortality rate, highlighting the urgency of improving diagnostic capabilities and therapeutic protocols in resource-limited settings to reduce morbidity and mortality associated with EM.