Abstract: OBJECTIVE To analyze the pathogen distribution and predisposing factors of pulmonary infection in patients with hypertensive cerebral hemorrhage, so as to provide guidance for clinical diagnosis and treatment. METHODS A total of 72 patients with hypertensive intracerebral hemorrhage and pulmonary infection from May 2012 to May 2016 in our hospital were selected (study group), while 80 patients with no pulmonary infection were chosen (control group) for predisposing factors analysis. The bacterial isolation and identification were carried out by microbial semi-automatic identification system. The distribution of pathogenic bacteria and drug sensitivity test were analyzed by K-B disk diffusion method. RESULTS Compared with control group, the incidences of the pulmonary infection were significantly increased of patients of study group of 60 years old or older, with diabetes and chronic bronchitis basis, the joint use of antibiotics in patients with more than three weeks of malnourished patients with swallowing dysfunction and consolidation, and the differences were significant (P<0.05). Totally 91 strains of pathogens were isolated from 72 patients, including 55 strains of gram-negative bacteria, 34 strains of gram-positive bacteria, and 2 stains of fungi, accounting for 60.4%, 37.4%, and 2.2%, respectively. The detection rates of Klebsiella pneumonia, Acinetobacter baumannii and Escherichia coli in gram-negative bacteria were high, accounting for 60.4%, 30.8% and 16.5%, respectively. The positive rates of Enterococcus and Staphylococcus aureus in gram-positive bacteria were high, accounting for 22.0% and 9.9%. The main fungus is Candida albicans, accounting for 2.2%. The gram-negative bacteria had high drug resistant rates to amino aminoglycosides, quinolones and the third generation of cephalosporins, some up to 100.0%, and were still sensitive to meropenem, imipenem, amikacin, and cefoperazone/sulbactam. The gram-positive bacteria were generally resistant to penicillin and clindamycin, but were still sensitive to vancomycin, teicoplanin, and rifampin. CONCLUSION The main predisposing factors of pulmonary infection in patients with hypertensive cerebral hemorrhage are age, history of chronic diseases basis (diabetes and chronic bronchitis) and the joint use of antibiotics and widespread malnutrition, and the pathogens were mainly gram-negative bacteria, which were sensitive to carbapenem antibiotics.