Sandfly fever virus, serotype Toscana (TOS), is endemic in some Mediterranean countries and causes sandfly fever (pappataci fever). In some patients, TOS may cause meningitis and meningoencephalitis. We report on two German adults returning from Italy with TOS-related meningitis, complicated in one case by abducens nerve palsy. TOS infection should be considered as a cause of acute central nervous system disorders in patients returning from areas of endemicity.