Background: The clinical characteristics of cryptococcal meningitis (CM) in young adults (≤ 40 years old) have not been reported. The purpose of this study was to delineate the clinical characteristics, laboratory findings and therapeutic outcomes of young adults with CM, and compare them with older adults (> 40 years old) with CM. Methods: Ninety-nine adult patients with CM (64 men, 35 women) were enrolled from 2002-2016, of whom 26 were ≤ 40 years old (young adult group) and 73 were > 40 years old (non-young adult group). The clinical characteristics, laboratory data and therapeutic outcomes of these two groups were compared. The prognostic factors of the young adult CM patients were analyzed, and the clinical characteristics and laboratory data between the young adult CM patients with and without acquired immune-compromised syndrome (AIDS) were compared. The modified Rankin scale (mRS) was used to evaluate the outcomes of the survivors at the time of discharge and at 1 year of follow-up. Results: The young adult CM patients had a significantly higher incidence of headache as the clinical presentation. There were no significant clinical differences between the young adult CM patients with and without AIDS. There were no significant prognostic factors in the young adult CM patients, but the young adult survivors had better outcomes (mRS score 0-2) than the non-young adult group. Conclusion: The young adult CM patients had a higher incidence of headache as the clinical presentation, and the young adult CM survivors had better clinical outcomes.