Epidemic cerebrospinal meningitis (CSM) is an acute respiratory infectious disease caused by Neisseria meningitidis (Nm) infection, often occurring and spreading in winter and spring. It primarily manifests as meningitis and bloodstream infection, which may occur simultaneously, but often presents with either meningitis or bloodstream infection alone as the main symptom. Based on the antigenic components of capsular polysaccharides, Nm can be classified into 12 serotypes, with A, B, C, W, X, and Y being the most common serotypes. On February 14, 2025, the Second Hospital of Lanzhou University reported one suspected adult case of epidemic CSM. Based on epidemiological characteristics, clinical manifestations, and laboratory test results, the case was diagnosed with group Y CSM. This case was the first adult case of epidemic CSM caused by group Y Nm in Gansu Province, with secondary brain abscess and bacteremia. The clinical team strived for the survival opportunity for the patient through precise diagnosis, multimodal life support and standardized critical care management, and successfully preventing permanent neurological deficits. This case highlights the need to strengthen pathogen surveillance and prevention of group Y epidemic CSM, with a focus on early identification of severe cases, precise selection of antimicrobial agents, and comprehensive treatment.