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ST1193 is an emerging new virulent and resistant clone among <i>Escherichia coli</i> with a tendency to spread rapidly across the globe. However, the prevalence of intracranial infection-causing <i>E. coli</i> ST1193 is rarely reported. This study aimed at determining the prevalence of <i>E. coli</i> ST1193 isolates, causing intracranial infections in Changsha, central China. A total of 28 <i>E. coli</i> isolates were collected from the cerebrospinal fluid of patients with intracranial infection over a four-year period. All isolates were differentiated using multilocus sequence typing (MLST), and phylogenetic grouping, and tested for antibiotic resistance. MLST analysis showed 11 sequence types (ST) among the 28 <i>E. coli</i> isolates. The most prevalent ST was B2-ST1193 (28.6%, 8/28), followed by B2-ST131 (21.4%, 6/28) and F-ST648 (10.7%, 3/28). Of the eight ST1193 isolates, three carried CTX-M-55, and one carried CTX-M-27. All eight ST1193 isolates were resistant to Ciprofloxacin, showing <i>gyrA</i>1AB/<i>parC</i>4A mutations. Two ST1193 isolates carried the <i>aac(6′)-Ib-cr</i> gene. All ST1193 isolates were recovered from infants with meningitis, with a fatal outcome for one three-month-old infant. ST1193 has emerged as the predominant type of <i>E. coli</i> strain causing intracranial infections in Changsha, China. This study highlights the importance of implementing appropriate surveillance measures to prevent the spread of this emerging public health threat.