We present a 54 year old man with external ventricular drainage who had multidrug resistant nosocomial Acinetobacter baumannii meningitis after operation for subdural hematoma and subarachnoidal hemorrhage due to car accident. He was treated with intravenous meropenem and colistin Following addition of intrathecal netilmycin a significant decrease in cerebrospinal fluid (CSF) cell number was detected. Multidrug resistant Acinetobacter baumannii meningitis has high mortality rates and as there is limited therapeutical options. Current treatments like intrathecal netilmycin and colistin should be kept in mind.