Meningitis is most likely in children under the age of 5 years, with a smaller peak in incidence in young adults aged 15-19 years. Following the incorporation of Haemophilus influenzae b (Hib) and group C meningococcus vaccines into the UK childhood immunisation schedule, the incidence of disease caused by these pathogens has declined. However, bacterial meningitis remains a severe illness that can cause death and, among survivors, morbidity (e.g. complications such as deafness, blindness, brain damage, loss of limbs). The role of corticosteroids in preventing such outcomes in bacterial meningitis has been widely researched over the last 40 years. Here we review the current evidence for the effectiveness and safety of corticosteroid use in the management of children with acute bacterial meningitis.