A surveillance system on meningococcal meningitis was set up in an Italian region in 1984, to monitor the trend and distribution of the disease, to acquire bacteriological data, to evaluate control measures. Results of the first two years show no overall increase in the of the disease, on the other hand an increased incidence in the 15-24 age group, a high fatality rate, a prevalence of serogroup C and serotype 2a and widespread resistance to sulfonamides were observed. Features characteristic of an epidemic period are thus present in the context of an endemic setting.