Melioidosis, caused by Burkholderia pseudomallei, is a rare but life-threatening infectious disease. Neurological involvement is uncommon but presents diagnostic challenges due to non-specific imaging findings and negative cultures. A 10-year-old female from Chennai (Tamil Nadu, India), presented with fever, cough, and bilateral upper extremity paralysis, which later progressed to involve the lower limbs. She had a history of recent treatment with Ceftriaxone following a reactive Widal test. Diagnosis was delayed due to multiple negative cultures from bodily fluids and nonspecific radiological findings. Cerebrospinal fluid analysis was suggestive of infection, and gram staining of a brain biopsy specimen revealed gram-negative rods with a characteristic ‘safety pin’ morphology, confirming B. pseudomallei infection. The patient received targeted antibiotic therapy and intensive medical care. Despite severe complications, she demonstrated clinical improvement and survived. Neurological melioidosis should be considered in cases of unexplained neurological deterioration, particularly in endemic regions or travellers from such areas. Early recognition and appropriate antimicrobial therapy are crucial for improving outcomes.