Naegleria fowleri causes primary amoebic meningoencephalitis, a fatal infection with profound implications for global health burden and water safety. Rising global temperatures and ageing water infrastructure are expanding the ecological range of this pathogen, increasing exposure risk in both high-income and resource-constrained settings. The infection mainly occurs through contact with warm freshwater and brackish waters and inhalation of cyst-laden dust; however, surveillance systems remain fragmented and under-resourced, particularly in low-income and middle-income countries. Diagnosis is often delayed or made post-mortem, and survival is exceedingly rare.