Mini review summarizes the long-term studies of pathology of pneumococcal meningoencephalitis on children’s, adult autopsy material and in experiment provided by the author and its collaborators. Pneumococcal meningitis in most severe cases includes brain matter lesions, to be considered as meningoencephalitis with high mortality. Nearby secondary lesions which can be regarded as complications of pneumonia, otitis and sinusitis, primary meningitis are not seldom. We can postulate the existence of highly virulent neurotropic strains of S. pneumoniae, leading to development of hypertoxic forms of the disease. The frequency of secondary brain lesions in pneumococcal pneumonia significantly arose during last decades.