Streptococcus suis is one of the most important swine pathogens world-wide. Among the serotypes described, type 2 is the serotype most frequently associated with disease. Despite increasing research in recent years, knowledge of virulence factors and the pathogenesis of the infection remain limited. This review discusses the currently available information on S. suis serotype 2 virulence factors and the pathogenesis of the meningitis caused by this important bacterial species. In addition, some hypotheses on the critical steps of the infection, such as bacterial invasion from mucosal surfaces to the bloodstream, survival of bacteria in blood, and invasion from blood into the central nervous system, are presented. Finally, the role that the stimulation of the immune system of animals (inflammatory reaction) could play during infection is also discussed. A complete understanding of the cell-interacting pathways that S. suis may follow inside the host could give important insights into the progression of disease. Further studies to delineate the mechanisms through which S. suis induces meningitis will contribute to the development of potential therapies for S. suis infections.