For over 100 years, major epidemics of meningococcal disease have occurred every few years within the African meningitis belt, which runs across the continent from Senegal to Ethiopia. The objectives of this review were to revise WHO guidelines on control of epidemic meningitis in subSaharan Africa concerning operational thresholds and vaccination responses, use of RDTs, use of single-dose antibiotic regimens, prophylaxis for household contacts. The outcomes of reviews of these four questions are presented in this guideline. Operational procedures on implementation of the guideline will be produced separately. The guideline only applies to countries of the extended meningitis belt and does not include guidance on vaccines, which is covered by a WHO position paper.