There is clear evidence for a host genetic component to meningococcal disease susceptibility with an increasing literature showing that genetic polymorphisms act as important determinants of both susceptibility and outcome. A large number of genes controlling susceptibility and outcome of meningococcal disease have been reported, but many of the associations have yet to be validated. A number of validated associations have been reported and these provide clues to key mechanisms influencing susceptibility and outcome. Identification of the genes involved in susceptibility and outcome of the disease may help in identifying those susceptible to the disease as well as providing important information on the immune pathways involved; and ultimately may identify new targets for therapeutic intervention.