Abstract: OBJECTIVE To analyze risk factors of Pseudomonas aeruginosa（PA） induced pulmonary infection and drug resistance of PA in patients undergoing tracheotomy in intensive care unit（ICU）. METHODS A retrospective analysis was performed on 35 ICU patients with PA pulmonary infection after tracheotomy in the Second Affiliated Hospital of Anhui University of Chinese Medicine from Jan. 2015 to Dec. 2019. Another 35 ICU patients without PA pulmonary infection after tracheotomy during the same period were enrolled as the non-infection group. The genera data such as age, gender, body mass index（BMI）, basic diseases, smoking history, diabetes history, indwelling gastric tube, glucocorticoid, usage time of antibacterial agents, tracheotomy time and serum albumin（ALB） in both groups were recorded. The full-automatic microbiological analyzer was applied in pathogen identification and drug susceptibility testing. Logistic regression analysis was applied to analyze risk factors of PA pulmonary infection in ICU patients undergoing tracheotomy. RESULTS PA pulmonary infection in ICU patients undergoing tracheotomy was related to glucocorticoids usage, usage time of antibacterial agents, tracheotomy time and serum ALB level（P＜0.05）. Glucocorticoids usage and prolonged tracheotomy time were all independent risk factors influencing PA pulmonary infection in ICU patients undergoing tracheotomy（P＜0.05）. The drug resistance rates of PA isolated bacterial strain were relatively higher to sulfamethoxazole（91.43%）, levofloxacin（91.43%）, ciprofloxacin（88.57%） and piperacillin（45.71%）, which were of certain sensitivity to amikacin（11.43%）, cefotaxime（17.14%） and ceftazidime（14.29%）. CONCLUSION A variety of factors can influence occurrence of PA pulmonary infection in ICU patients undergoing tracheotomy. Clinically, general situations of patients and results of drug sensitivity test could be combined with, and amikacin can be preferentially selected.