Objective To discuss the risk factors and pathogenic distribution of hospital-acquired pneumonia(HAP) in elderly patients and to perform the drug sensitivity analysis. Methods A total of 206 HAP patients were included from January 2006 to April 2012 in Chinese PLA 161st Hospital. Their clinical data and sputum culture results were analyzed retrospectively. Susceptibility test was carried out by Kirby-Bauer method according to CLSI2009. Results All 206 subjects suffered from multiple basic diseases and presented with many risk factors. Totally 215 strains were isolated, including gram negative bacteria(61.55%), gram positive cocci(26.63%) and Fungi(2.43%), respectively. Most bacilli were susceptible to imipenem and meropenem, and gram positive cocci to vancomycin and linezolid. Conclusions For elderly HAP patients, control of risk factors, detection of pathogens and use of antibiotics according to drug susceptibility will help to acquire satisfactory therapeutic effect and reduce the drug resistant strains.