Introduction: Post–spinal anesthesia bacterial meningitis is an exceptional complication, most often caused by Gram-positive cocci originating from the oropharyngeal flora. Infections due to Escherichia coli are extremely rare and are generally reported as isolated cases. Case Report: We report the case of a 37-year-old woman with no previous medical history who developed altered consciousness twelve hours after a cesarean section performed under spinal anesthesia. Clinical examination revealed obnubilation, neck stiffness, and cloudy cerebrospinal fluid. Cerebrospinal fluid culture isolated Escherichia coli sensitive to ceftriaxone. A breach in aseptic technique was identified, involving the use of the paper inner packaging of a pair of surgical gloves as an operative drape. Early antibiotic therapy with ceftriaxone combined with corticosteroid therapy resulted in a favorable outcome without sequelae after 21 days of treatment. Conclusion: This case illustrates the rare but serious occurrence of Escherichia coli meningitis following spinal anesthesia and highlights the importance of strict aseptic technique, rapid diagnosis, and early antibiotic treatment. Exclusive use of certified sterile surgical drapes remains an essential preventive measure.