Abstract: OBJECTIVE To analyze the bacterial flora distribution and risk factors for multidrug-resistant organisms (MDROs) infection in elderly patients with diabetic foot. METHODS A total of 202 elderly patients with diabetic foot infection admitted to the People's Hospital of Yanhu District in Yuncheng City from Jun 2018 to Jan 2022 were included in the study. According to whether MDROs infection occurred, patients were divided into the MDROs infection group (n=87) and non-MDROS infection group (n=115), and clinical data of these patients were retrospectively collected. The bacterial community distribution of MDROs in elderly diabetic feet infection was analyzed, the risk factors for elderly diabetic feet MDROs infection were analyzed by univariate and multivariate analysis. RESULTS There were 87 cases of MDROs infection in 202 elderly patients with diabetic foot infection, with an incidence of 43.07%. A total of 99 strains of pathogenic bacteria were isolated, mainly gram-negative bacteria, among which the top three pathogens were Staphylococcus aureus (33.33%), Escherichia coli (21.21%) and Proteus mirmirum (16.16%). Multivariate logistic analysis showed that osteomyelitis, long-term use of antibiotics, ischemic nerve wound, glycated hemoglobin (HbA1c) ≥7% were the risk factors for elderly diabetic feet MDROs infection (P＜0.05). CONCLUSION The incidence of MDROs infection in elderly diabetic feet was 43.07%, and the main strains were gram-negative bacteria. Many factors were related to the occurrence of MDROs infection in elderly diabetic feet, and preventive intervention could be carried out for high-risk patients.