Background: Meningitis is a major public health problem needing timely diagnosis, appropriate treatment, prevention and control. Despite the advances in diagnosis and treatment of infectious diseases, meningitis is still considered as an important cause of mortality and morbidity, especially in the pediatric population of lower income countries such as the Democratic Republic of the Congo (DR Congo). In this study, we aimed to analyze the fatality aspect of suspected meningitis among children under five years. Materials and Methods: A prospective, descriptive study carried out in the Pediatrics departments of four hospitals in the South-Kivu province in the Eastern part of the DR Congo from April 2021 to March 2022. Of the 1,386 children enrolled, 251 children were suspected of meningitis. This study captures data generated in the framework of routine medical practice, which includes medical history, clinical diagnosis and Results of locally conducted laboratory tests.  Results: Throughout the study period, a total of 251 patients (18.1%) aged 1 month to 59 months with suspected meningitis were recruited out of 1386 children hospitalized in the Pediatrics.  The fatality among hospitalized children with suspected meningitis during the study period was 27.9%, however the mortality linked to meningitis decreases with age, ranging from 37.5% among children under 2years to 19.4% among those over 2 years old. Children hospitalized for meningitis with malnutrition as an underlying conditions, had a 3.5 times greater risk of dying. The case fatality rate was higher in transferred and not vaccinated children respectively (2.3 and 2.5 times). We observe that the death occurs early within the first 3 days. Conclusions: Our study noted a higher fatality rate in children with suspected meningitis; that could be probably be linked to the gape in vaccination and malnutrition as underline condition.