Background: Intracranial intratumoural abscesses are rare occurrences typically treated with antibiotics and possible surgical resection. This study describes a meningioma-associated abscess and a review of the literature. Methods: Medical records and investigations were reviewed. A literature search of PubMed was completed. Results: A 56-year-old male presented with septic shock and dysuria. Urine culture isolated E. Coli, and he was treated with Ertapenem prior to discharge. A CT scan was ordered during hospitalization for unrelenting headaches, revealing a meningioma. Conservative management with follow-up as an outpatient was decided. However, he returned within two weeks with a fever and progressive left-sided weakness. A right frontal craniotomy for tumour resection was performed, and culture of necrotic-appearing tissue within the tumour revealed E. Coli. He was treated with Meropenem for six weeks, and at follow-up, the patient was asymptomatic. Our scoping review illustrated that 18 meningioma-associated abscesses have been reported in the literature since the first report in 1994. Conclusions: This case highlights the hematogenous spread of a urinary infection, resulting in an intratumoural abscess. Review of the literature indicated that, similarly, 39% of cases had recent or concurrant urinary tract infections. Future studies should seek to determine conclusive guidelines for diagnosing intratumoural abscesses.