Abstract: OBJECTIVE To investigate the distribution and drug resistance of pathogens causing pulmonary infections in neurosurgery intensive care unit (NICU) hypertensive cerebral hemorrhage patients undergoing tracheotomy so as to provide guidance for reasonable clinical use of antibiotics and treatment of the pulmonary infections. METHODS The sputum culture was carried out for 79 NICU hypertensive intracerebral hemorrhage patients who underwent the tracheotomy from Aug 2013 to Aug 2015, and the distribution and drug resistance of the pathogens were observed. RESULTS A total of 223 strains of pathogens were isolated from the submitted specimens that were obtained from the 79 patients, including 167 (74.89%) strains of gram-negative bacteria and 56 (25.11%) strains of gram-positive bacteria; the Klebsiella pneumoniae and Pseudomonas aeruginosa were the major species of the gram-negative bacteria, accounting for 30.49% and 17.94%, respectively; Staphylococcus aureus was the predominant species of the gram-positive bacteria, accounting for 15.25%. The drug resistance rates of the gram-negative bacteria to ceftriaxone and piperacillin were more than 55.00%; the drug resistance rates of the gram-positive bacteria to ampicillin, fusidic acid, cefazolin, and oxacillin were more than 97.00%. CONCLUSION The gram-negative bacteria and gram-positive bacteria are the common pathogens causing the postoperative pulmonary infections in the NICU hypertensive intracranial hemorrhage patients undergoing the tracheotomy and are highly resistant to the antibiotics; it is necessary for the hospital to reasonably use antibiotics for the treatment.