Abstract: OBJECTIVE To surveil the distribution of clinical isolates from emergency department patients and antimicrobial susceptibility. METHODS According to technical programs of China Antimicrobial Resistance Surveillance System (CARSS), the surveillance data were collected from emergency departments, members of CARSS, from Oct 2020 to Sep 2021. The specimen sources, key antimicrobial resistance surveillance indexes and drug resistance rates of 99 406 strains of bacteria were statistically analyzed by WHONET 5.6 software. RESULTS From Oct 2020 to Sep 2021, the result of CARSS showed that the isolation rate of methicillin-resistant Staphylococcus aureus was 35.2%, vancomycin-resistant Enterococcus faecium 2.8%, carbapenem-resistant Acinetobacter baumannii 68.6%, carbapenem-resistant Pseudomonas aeruginosa 21.4%, carbapenem-resistant Klebsiella pneumoniae 17.1%, higher than the average isolation rate of 2021. The isolation rates of other common drug-resistant bacteria parallels the national level. CONCLUSION The clinical isolates from the emergency department patients are highly resistant to antibiotics, especially methicillin-resistant S.aureus, vancomycin-resistant E.faecium and carbapenem-resistant gram-negative Bacilli.