Abstract: OBJECTIVE To explore the distribution and drug resistance of pathogens causing pulmonary infections in elderly patients with cerebral infarction and put forward the prevention measures so as to provide theoretical basis for treatment of the elderly patients with cerebral infarction complicated with pulmonary infections. METHODS A total of 82 elderly patients with cerebral infarction who were complicated with pulmonary infections from Feb 2013 to Feb 2015 were recruited as the study objects, then the respiratory tract deep sputum specimens were collected for culture of pathogens, the isolated pathogens were identified by using VITEK-2 system of BioMérieux, France, the drug susceptibility testing was performed, and the statistical analysis was performed with the use of SPSS19.0 software. RESULTS Totally 172 strains of pathogens were isolated from the submitted specimens that were obtained from the 82 elderly patients with pulmonary infections, including 114 (66.28%) strains of gram-negative bacteria and 58 (33.72%) strains of gram-positive bacteria. The drug resistance rate of the gram-negative bacteria to meropenem was the lowest (5.26%); the drug resistance rates to ciprofloxacin, cefepime, gentamicin, and levofloxacin were 91.23%, 89.47%, 83.33%, and 81.58%, respectively. The drug resistance rates of the gram-positive bacteria to penicillin, levofloxacin, chloromycetin, and gentamicin were 93.75%, 84.38%, 78.13%, and 78.13%, respectively; the drug resistance rate to vancomycin was 0. CONCLUSION The elderly patients with cerebral infarction tend to have pulmonary infections due to disturbance of consciousness. The gram-negative bacteria are dominant among the pathogens causing the infections. It is necessary for the hospital to reasonably use antibiotics based on the results of the culture of pathogens and drug susceptibility testing.