Abstract: OBJECTIVE To discuss the risk factors, common pathogens and drug resistance lung infection in elderly patients with heart failure, so as to provide prevention and treatment measures to reduce heart failure patients the incidence of pulmonary infection. METHODS A total of 1 184 cases of patients with heart failure in our hospital from Sep. 2014 to Dec. 2015 were selected, whose basic information was under statistical analysis to know the infection rate of pulmonary infection. Infected sputum or lower respiratory tract secretions were taken for bacterial culture parallel analysis of drug resistance. RESULTS From the 1 184 cases, there were 99 cases of patients with pulmonary infection, pulmonary infection rate 8.36%. Age group > 70 years, class IV heart function, respiratory disease and diabetes combined were relevant factors for pulmonary infection, and the difference was statistically significant (P<0.05). From 99 cases of pulmonary infection 132 strains of pathogens were detected, including gram-negative bacteria detected in 82 strains, accounting for 62.12%, gram-positive bacteria detected in 33 strains, accounting for 25.00%, fungal detected in 17 strains, accounting for 12.88%. Drug resistance of gram-negative bacteria to ciprofloxacin and amikacin generally higher reached to 39.02% and 36.59%, but to piperacillin/tazobactam resistance rates were low, only 15.85%. Drug resistance rates of gram-positive bacteria to general cefazolin, penicillin and erythromycin were higher, reaching 100.00%, 90.91% and 84.85%, but non-resistance to linezolid, and only 3.03% to vancomycin. CONCLUSION The incidence of elderly patients with heart failure complicated with lung infection has a variety of factors, in the clinical care process special attention should be given.Once the infection occurs, antibiotics could be used combined as experience told at the beginning, and according to the etiology and drug resistance to check and adjust antibiotics.