Analysis of Glasgow's devastating 1907 meningococcal epidemic reveals household overcrowding as the primary driver of transmission, not geographic proximity between households. The outbreak killed approximately 1,000 people with a 70% case fatality rate, predominantly affecting infants and young children. Crucially, areas with high disease incidence during the epidemic maintained elevated risk patterns in subsequent outbreaks decades later. This historical epidemiological analysis offers sobering insights for modern public health preparedness. While antibiotic treatment has dramatically improved meningococcal outcomes today, the fundamental transmission dynamics identified—household crowding as a key risk amplifier—remain relevant for respiratory and droplet-transmitted diseases. The persistence of spatial risk patterns suggests that social and housing determinants create lasting vulnerability in specific communities. However, this preprint analysis of century-old administrative records awaits peer review, and historical data quality limitations must be considered. The findings reinforce that infectious disease interventions should prioritize historically high-incidence areas rather than assuming uniform geographic risk distribution.