Abstract: Objective To explore the course of treatment and decrement method of dexamethasone in the treatment of tuberculous meningitis, and to improve the cure rate and reduce the adverse outcome. Methods Thirty-seven patients with tuberculous meningitis treated in the Twelfth People’s Hospital of Chongqing from 2008—2012 were enrolled in this study. The dose and course of treatment with dexamethasone, and the clinical outcome were analyzed retrospectively. Results After diagnosis confirmed, all of 37 patients were given the anti-tuberculosis treatment with 3-6HREZ/15HRE or 2HREZS/1-4HREZ/15HRE, and glucocorticoid was simultaneously administered (intravenous drip dexamethasone 10 mg/d). Meanwhile, all of them were given intrathecal injection of isoniazid and dexamethasone once or twice a week. During the deduction of dexamethasone, 13 patients’ illness were repeated, among whom 8 cases reduced hormone within 1 month treatment. The symptoms of 6 patients whose protein of the cerebrospinal fluid fluctuated were not exacerbated. After 2-3 months prolonged treatment with glucocorticoid, cerebrospinal fluid protein recovered to normal. The 18 patients whose illness was not repeated were given dexamethasone 10 mg/d for 2-3 months followed by the decrement of dexamethasone. Among 37 patients, 30 patients were followed up routinely and were clinically cured, 9 cases had sequela of dysnoesia, neurological or mental disorder. Conclusion The course of treatment of glucocorticoids in treatment of tuberculous meningitis should be prolonged, and the decrement of dexamethasone after 2-3 months can reduce the occurrence of illness repeated