Streptococcus gallolyticus (S. gallolyticus) is a Gram-positive group D streptococcus, belonging to Streptococcus bovis/Streptococcus equinus complex (SBSEC). This bacterium is an opportunistic pathogen that can cause infections in multiple sites and organs. However, the reports of bloodstream infection caused by S gallolyticus in patients with decompensated cirrhosis are rare. In this case, the patient developed diarrhea and fever after eating unclean food. Blood culture was obtained during chills and fever, and a strain of Gram-positive bacteria was isolated. The biochemical methods and 16S rRNA gene sequencing were used to identify the bacterial strain as Streptococcus gallolyticus subsp. gallolyticus. According to the results of antimicrobial susceptibility test, the patient was given meropenem 0.5 g q8h for 7 days and levofloxacin 0.5 g qd for another 7 days. The patient’s temperature returned to normal after the treatment.