Background: The "white cerebellum" sign is a rare imaging finding described mainly in children with hypoxic brain injury. Materials and Methods: Single case report and review of the literature. Findings: We describe a child with acute bacterial meningitis in whom plain CT and MRI showed the white cerebellum sign. The subtle imagings findings were not recognized and a lumbar puncture was performed. Markedly increased intracranial pressure was documented by lumbar puncture and by placement of an intraparenchymal monitor. Contrary to most prior descriptions the patient made a very good recovery. Conclusions: The white cerebellum sign is a subtle imaging finding seen in patients with diffuse cerebral edema, such finding may not be as ominous as previously thought. © 2013 Springer Science+Business Media New York.