This paper reports a case of severe meningitis caused by Angiostrongylus cantonensis in a child. The child presented with fever and vomiting as initial symptoms, with elevated eosinophil counts in peripheral blood and cerebrospinal fluid. Head magnetic resonance imaging (MRI) revealed progressive encephalitis changes, and meta-genomic next-generation sequencing (mNGS) of cerebrospinal fluid detected specific sequences of Angiostrongylus cantonensis. After multidisciplinary comprehensive treatment, the child’s condition continued to deteriorate, ultimately leading to death. Therefore, for young children with meningitis complicated with elevated eosinophil counts of unknown cause, the possibility of Angiostrongylus cantonensis infection should be considered as early as possible in clinical practice, and relevant pathogen-related examinations should be performed promptly.