Objective To investigate the distribution and clinical characteristics of multidrug-resistant (MDR) bacteria in the elderly patients with pulmonary infection. Methods Included in the study were 219 elderly patients with pulmonary infection attending the Department of Geriatrics of Xijing Hospital from January 2015 to December 2016. They were divided into MDR group (n=107) and non-MDR group (n=112) based on the presence of MDR bacteria. An analysis was made of the distribution of MDR bacteria in the former, the two groups were compared in the clinical indicators of the patients, and the risk factors were investigated for MDR infection. SPSS statistics 18.0 was used for data processing. Depending on data type, t-test or χ² test was performed for comparison between groups, and multivariate logistic regression for investigation of independent risk factors for MDR infection. Results Infections by Acinetobacter baumannii and Pseudomonas aeruginosa were more common in the MDR group. One-year mortality was significantly higher in the MDR group than that in the non-MDR group [30.2%(32/106) vs 8.0%(9/112), P<0.05]. Multivariate logistic regression showed that long hospital stay (OR=4.813,5%CI 1.234-5.554; P=0.032), long antibiotics medication (OR=3.124, 95%CI 2.126-10.314; P=0.001) and prolonged use of the invasive ventilator (OR=4.227,5%CI 1.470-6.879; P=0.041) were independent risk factors for the MDR infection. Conclusion Pulmonary MDR infections in the elderly are mostly caused by Acinetobacter baumannii and Pseudomonas aeruginosa. Patients with MDR infections have high mortality. Long hospitalization, long antibiotic medication, and prolonged use of the invasive ventilators are independent risk factors for MDR infections.