The ubiquitous Acinetobacter baumannii is an important and troublesome pathogen of nosocomial infection. Multidrug-resistant A baumannii meningitis is very difficult to treat, usually with high mortality. The disease is generally associated with craniotomy, but rarely with lumbar puncture. However, in our case, a 45-year-old male construction worker suffered multidrug-resistant A baumannii meningitis associated with lumbar puncture. The patient responded poorly to the initial treatment with an intravenous infusion of tigecycline. However, later treatment with an intrathecal injection of tigecycline (concentration 1 mg/mL) at a dose of 10 mg every 12 hours proved to be highly efficacious. Thus, intrathecal injection of tigecycline should be seriously considered as a treatment for multidrug-resistant A baumannii meningitis.