Abstract: OBJECTIVE To investigate the pathogen distribution and drug resistance of postoperative acute appendicitis incision infections in children, so as to provide a theoretical basis for an effective treatment to clinical appendicitis incision infection. METHODS A total of 597 cases of acute appendicitis in children from Oct. 2012 to Oct. 2015 admitted to our hospital were selected as research subjects. The infection rate of postoperative wound infection, pathogen distribution and antimicrobial susceptibility test were analyzed. SPSS 19.0 was used for data analysis. RESULTS There were 52 cases from 597 cases had postoperative infection in children with acute appendicitis, and the infection rate was 8.71%. A total of 68 strains of pathogens were cultured, and 42 strains of gram-negative bacteria, accounting for 67.76%, 26 strains of gram-positive bacteria, accounting for 38.24%. Antimicrobial resistance rates of E. coli up to amoxicillin was 56.25%; Klebsiella pneumoniae resistance rates to gentamicin was the highest 100.00%; Pseudomonas aeruginosa resistant rate to ceftazidime was the highest 91.67%. Antimicrobial resistance rates of Staphylococcus aureus to ceftriaxone was the highest 55.56%; the resistance rates of Enterococcus faecalis, to clindamycin and tetracycline were all in high level 80.00%. The resistant rates of coagulase-negative Staphylococci to clindamycin and tetracycline were 80.00%. CONCLUSION The cause of acute appendicitis in children with postoperative infection mainly is gram-negative bacteria, gram-positive bacteria followed, which have a high drug resistance to commonly used antimicrobials. Therefore, antibiotics supervision strengthen, preventing overuse of antibiotics, rational choice of targeted antibiotic therapy, can improve the therapeutic effect and quality of life of patients, which should be paid attention in clinic.