Neonatal bacterial meningitis (NBM) is one of the causes of long-term morbidity and mortality in childhood. The present study was conducted at the Special Care Baby Unit (SCBU) of the Federal Medical Centre (FMC), Keffi, Nasarawa State, north-central Nigeria with objectives of evaluating the burden, bacterial profile and antimicrobial susceptibility of prevailing organisms causing neonatal meningitis. It was a prospective, descriptive study conducted between August and November 2018. Sixty-seven neonates who met the inclusion criteria, of the 204 admissions in the SCBU during the period participated in the study. Sociodemographic and clinical data on each neonate recruited was collected through the use of a structured questionnaire. Samples for blood culture were analysed by continuous monitoring blood culture system using BACTEC® pedplus bottles and cerebrospinal fluid (CSF) by gram stain microscopy and culture technique with antibiotic sensitivity testing of all isolates. Approximately 1 in every 2 neonate presented with early onset infections (53.7%). The male to female ratio was 1:1.03. Twenty-three neonates (34.3%) had antibiotics before lumbar puncture was performed and 17 (73.9%) of these were diagnosed with meningitis. Fever was the most common presenting clinical feature with 2/3rd of all admission temperatures greater than 37.70C. Thirty-seven (55.2%) of the 67 neonates who presented with clinical criteria for the diagnosis of severe bacterial infection by IMCI/WHO were diagnosed with meningitis. All the thirty-seven neonates’ CSF samples were positive on gram stain. Six CSF and 14 blood samples were culture positive at 8.9% and 20.9% respectively. All CSF culture positive samples yielded Escherichia coli (E. coli) while 64.7% of positive blood cultures yielded Staphylococcus aureus (S. aureus). E. coli was susceptible to Cefoxitin, Chloramphenicol, Ciprofloxacin, Amikacin and Imipenem while all S. aureus isolate was susceptible to Amoxicillin/clavulanic acid, Amikacin, Imipenem and Vancomycin followed by 90% susceptibility to Ampicillin/sulbactam and Ciprofloxacin, 80% susceptibility to Chloramphenicol and 70% susceptibility to Gentamycin and Cefoxitin. The SCBU first line antibiotics consist of Ampicillin/sulbactam and Gentamycin. The sensitivities of the unit empiric antibiotics to gram negative and gram positive organisms are 33% and 90% for Ampicillin/sulbactam and 66% and 83% for Gentamycin respectively. There might be a diminished ability of the first line antibiotics to combat infections caused by prevailing organisms in the unit. The case fatality rate in the study was 2.7% with no immediate complication at discharge. In conclusion, neonatal meningitis (NM) occurs in approximately 1 in every 5 SCBU admissions in this study. Gram stain analysis of CSF should be performed as soon as possible in neonates with suspected meningitis to improve diagnostic yield in NM. Community awareness and capacity building in neonatal units on infection control is imperative.