Abstract: Objective To deepen the clinicians’ understanding of Ralstonia pickettii meningitis. Methods Clinical data of 1 case of meningitis caused by Ralstonia pisiella were retrospectively analyzed. Literature review was conducted from CNKI, Wanfang Data, Chongqing Vip and PubMed databases by using the keywords of Ralstonia pickettii and meningitis. Relevant clinical data were summarized. Results The patient was admitted to our hospital due to fever, headache, nausea and vomiting and diagnosed with Ralstonia pickettii meningitis by metagenomic next-generation sequencing （mNGS）. The patient was discharged after effective anti-infection therapy of meropenem. No drug therapy was given after discharge. No recurrence was observed during 3-month follow-up. According to literature review, 3 cases of Ralstonia pickettii meningitis were identified. Among them, 2 cases had a history of intracranial surgery and 1 case was premature infant. All of them were cured by active anti-infection treatment. Conclusions Ralstonia pickettii remains an extremely rare cause of meningitis in clinical practice. Application of mNGS can improve the diagnostic accuracy of this disease.