Parameningeal infections are relatively uncommon. Focal intracranial infections are divided into three main categories based on their anatomic location: brain abscess, spinal epidural abscess, and subdural empyema. All three of these focal infections arise either from direct spread from contiguous infections such as sinusitis, otitis media, or cranial osteomyelitis; hematogenous seeding during bacteremia; or as a result of a penetrating injury. The clinical manifestations of parameningeal infections vary based on the site of infection. Symptoms and signs of brain abscess and subdural empyema include fever, headache, vomiting, seizures, and altered mental status. Spinal epidural abscesses present with fever, back pain, and focal neurological deficits. The diagnostic evaluation of parameningeal infections requires advanced imaging technology. Magnetic resonance imaging is preferred in most instances. Management of these infections requires a multidisciplinary approach, consisting of a combination of neurosurgical intervention and appropriate long-term antibiotic therapy. Depending on the clinical circumstances, searching for an underlying source for the parameningeal infection may need to be pursued.