Abstract: Objective:To investigate the value of early brain MR combined with cerebrospinal fluid (CSF) parameters in predicting the outcomes of full-term neonatal bacterial meningitis. Methods: A retrospective cohort study analyzed hospitalized full-term infants with bacterial meningitis, using the discharge outcomes as the cohort endpoint (good prognosis group and poor prognosis group), and early brain MR semi-quantitative scoring system and/or CSF examination (CSF white blood cells, CSF protein, CSF glucose) as predictive indicators, to evaluate the value of different methods in predicting the outcomes of full-term neonatal bacterial meningitis. Results: One hundred and eighty-nine full-term infants with bacterial meningitis who met the inclusion and exclusion criteria of this study were included in our analysis. Among them, 108 (57.1%) were male; the gestational age ranged from 37 to 42.3 weeks; the birth weight was 2,100~5,000 g; 132 (69.8%) were delivered vaginally; the age of onset was from 1 to 28 d; the hospitalization stay was 4~129 d. There were 162 (85.7%) and 27 (14.3%) cases in the good and poor prognosis groups respectively and there were no statistically significant differences in gestational age, birth weight, gender, delivery method, age of onset and brain MR examination time between the two groups. The area under curve (AUC) of the combination of brain MR scores and CSF protein, brain MR scores, CSF protein, CSF white blood cells, CSF glucose was 0.902, 0.875, 0.788, 0.728, 0.248, respectively. The cut-off value of brain MR scores was 17 points, and that of CSF protein was 2,316 mg·L-1. There was no statistically significant difference in AUC between the brain MR scores and CSF protein, and the difference between the combination indicator and CSF protein was statistically significant, but there was no statistically significant difference between the combination indicator and brain MR scores. Sensitivity and specificity of the combination indicator with brain MR scores were 88.9% (95%CI: 84.4%~93.4%) vs 77.8% (95%CI: 71.9%~83.7%), 80.9% (95%CI: 75.3%~86.5%) vs 82.7% (95%CI:77.3%~88.1%), respectively. Conclusion: The combination of early brain MR scores and CSF protein improved the accuracy of predicting the prognosis outcomes of full-term neonatal bacterial meningitis.