Meningitis remains a major health burden throughout Sahelian Africa, especially in heavily populated northwest Nigeria with an annual incidence rate ranging from 18 to 200 per 100 000 people for 2000-11. Several studies have established that cases exhibit sensitivity to intra- and inter annual climate variability, peaking during the hot and dry boreal spring months, raising concern that future climate change may increase the incidence of meningitis in the region. The impact of future climate change on meningitis risk in north west Nigeria is assessed by forcing an empirical model of meningitis with monthly simulations of seven meteorological variables from an ensemble of 13 statistically downscaled global climate model projections from phase 5 of the Coupled Model Inter comparison Experiment (CMIP5) for representative concentration pathway (RCP) 2.6, 6.0, and 8.5 scenarios, with the numbers representing the globally averaged top-of-the-atmosphere radiative imbalance (in Wm22) in 2100. The results suggest future temperature increases due to climate change have the potential to significantly increase meningitis cases in both the early (2020-35) and late (2060-75) twenty-first century, and for the seasonal onset of meningitis to begin about a month earlier on average by late century, in October rather than November. Annual incidence may increase by 47%6 8%, 64%6 9%, and 99%6 12%for the RCP 2.6, 6.0, and 8.5 scenarios, respectively, in 2060-75 with respect to 1990-2005. It is noteworthy that these results represent the climatological potential for increased cases due to climate change, as it is assumed that current prevention and treatment strategies will remain similar in the future.