OBJECTIVE: To systematically review the related evidence-based guidelines of purulent meningitis in children, and to provide evidence-based reference for clinical treatment. METHODS: Retrieved from PubMed, EMBase, CBM, Wanfang Database, CJFD and VIP, NGC, GIN, TRIP and websites of domestic and international medical associations and industry bodies, the treatment guidelines about purulent meningitis in children were collected. Evidence-based evaluation was performed after data extraction and quality evaluation. RESULTS: Finally 3 guidelines were enrolled in total, with development time ranging from 2004 to 2012, from USA, Britain and Australia, respectively. All of the recommendations were level B, "scope and purpose" and "clarity" showed the higher scores in AGREEⅡ, more than 70%, and "applicability" showed generally low scores. Penicillin and cefotaxime were recommended in purulent meningitis of neonates, and vancomycin combined with cefotaxime or ceftriaxone were recommended for infants and children(it was combined with vancomycin when Streptococcus pneumoniae infection was suspected). The dose and duration of each guideline were certain different, and the period of treatment should be longer in neonates. In addition, the glucocorticoid was recommended in all guidelines. CONCLUSIONS: The recommendations of medicines for the treatment of purulent meningitis are basically unanimous, with no regional difference, but there are some differences about dose and the course of treatment. In addition, the classification criteria of the levels of evidence and recommendation are still suboptimal, which needs further improvement. And guidelines on purulent meningitis should be improved in "rigour" and "applicability" in future.