To investigate the clinical features, diagnosis, treatment, and prognosis of central nervous system (CNS) infections caused by Listeria monocytogenes(LM) in non-perinatal adults. Methods: A retrospective analysis was conducted on 6 cases of non-perinatal CNS-LM infection in adults at our hospital, combined with a review of the literature. Results: Among the 6 patients, 3 were male and 3 female, with a median age of 56.5 years (range: 43-70 years). All patients presented with high fever (>39℃). Neck stiffness was observed in 5 cases, and 4 of them exhibited the classic triad of fever, impaired consciousness, and neck stiffness. Five patients had focal neurological deficits, and seizures occurred in 3. Cerebrospinal fluid (CSF) metagenomic next-generation sequencing (mNGS) was performed in 5 patients, and LM-specific sequences were detected in all. Blood culture and CSF culture were positive in 3 cases each. Neuroimaging revealed meningeal enhancement in 2 cases, rhombencephalitis in 1, hydrocephalus in 2, and concomitant lumbosacral meningeal and nerve root enhancement in 1. The median time from symptom onset to diagnosis was 12.5 days (range: 4-63 days). After diagnosis, 3 patients received first-line therapy with ampicillin (or penicillin) combined with gentamicin. Ultimately, 1 patient was cured, 3 showed clinical improvement but had residual neurological sequelae, and 2 died after withdrawal of treatment due to critical illness. A search of 317 previously reported cases of CNS-LM infection revealed that the most common manifestations were meningitis and meningoencephalitis. Among all cases, 7% presented as brainstem encephalitis and less than 1% of cases involve concurrent myelitis and radiculitis. Conclusion: The clinical presentation of CNS-LM infection in adults is highly heterogeneous. For patients presenting with brainstem symptoms or lumbosacral nerve root symptoms, the possibility of LM infection should be considered. CSF mNGS can significantly improve pathogen detection and is valuable for early diagnosis. Empirical antimicrobial therapy should cover LM. Early initiation of adequate, combination therapy with sensitive antibiotics for a sufficient duration may help improve patient prognosis.