Background: Meningitis is a significant public health problem due to the risk of permanent neurological complications and a potentially life-threatening course. Its etiology is diverse, and the distribution of infectious agents depends on patient age, seasonality, and environmental factors. Objective: The study aimed to characterize the etiology of meningitis in the Podlaskie Voivodeship based on the analysis of cases hospitalized at the Department of Infectious Diseases and Neuroinfections of the Medical University of Białystok between 2022 and 2024. Material and methods: This study presents a retrospective analysis of cases of meningitis hospitalized between 2022 and 2024 at the Department of Infectious Diseases and Neuroinfections of the Medical University of Bialystok. The analysis included a review of medical records with regard to the etiology of infection as well as selected epidemiological and demographic characteristics. Results: During the analyzed period, viral etiology predominated (67%), with tick-borne encephalitis (TBE) accounting for approximately 55% of cases. The proportion of cases with unknown viral etiology increased from 6.9% in 2022 to 12.7% in 2024. Bacterial etiology was identified in 13% of patients. The incidence of neuroborreliosis decreased from 6.9% in 2022 to 2.2% in subsequent years (2.5% overall). Single cases were caused by Haemophilus influenzae and Streptococcus pneumoniae. Abscesses and granulomas of the central nervous system accounted for 4.8% of all cases. Conclusions: In 2022-2024, meningitis in north-eastern Poland was characterized by a predominance of viral etiology, particularly infections caused by tick-borne encephalitis virus, with an increasing trend. An increase in cases of unknown etiology was also observed. Bacterial infections accounted for a smaller proportion of cases, which may reflect the effectiveness of vaccination programs. These trends are consistent with national and European data and highlight the growing importance of environmental factors, as well as the need to strengthen prevention and improve diagnostic strategies.