The Australian resident, recently returned from New Zealand, died in Royal Prince Alfred Hospital, NSW Health said.
Health authorities in New Zealand had been informed and all people who had contact with the woman in Australia had been followed up for testing, it said.
Sydney South-West Area Health Service director Dr Stephen Conaty said the death was a reminder of the need for vigilance.
"Most people who contract the disease make a full recovery, however, this is a sad reminder that meningococcal disease can strike quickly and can be fatal," he said in a statement on Monday.
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"In the past year we have seen a number of cases of meningococcal disease outside the winder/spring peak period."
Meningococcal is a bacterial infection that causes either meningitis, where the lining of the brain and spinal cord become inflamed, or septicaemia (blood poisoning).
Early symptoms include leg pains, cold hands and feet and abnormal skin colour.
Later symptoms can include high fever, headaches, neck stiffness, nausea, vomiting, rashes and drowsiness.
The two main strains of the meningococcal disease in Australia are types B and C.
Dr Conaty said people who have had the meningococcal C vaccine should still be alert for symptoms as the vaccine does not protect against the more common type B infection.
