Objective To investigate the information of pathogenic bacteria and drug resistance in patients with chronic heart failure and lower respiratory infections. Methods A retrospective review was adopted to analyze the results of sputum culture and susceptibility tests among 126 patients with chronic heart failure and lower respiratory infections. The pathogen distribution and drug resistance was analyzed statistically. Results Of 203 samples of sputum culture, 182 strains of pathogenic bacteria were found, including 139 strains of bacteria that consisted of 65.5% (91/139) Gram-negative bacteria and 34.5% (48/139) Gram-positive bacteria, and 43 strains of fungus. In 126 patients with chronic heart failure, 41 patients had the drug sensitivity in good agreement with empirical treatment, and 68 patients had poor infection controlled according to sputum culture or in combination with antibiotics after the replacement of the majority of infections under control, and 17 cases were dead as apparent drug resistance and infection without control, and the hospital mortality was 13.5%. Conclusion The lower respiratory infections in patients with chronic heart failure are mostly due to Gram-negative bacteria, and antimicrobial resistance was commonly evident. Rational use of antibiotics and avoiding drug abuse are the key for preventing bacterial resistance.