Objective To investigate the distribution and clinical characteristics of multidrug-resistant organisms (MDROs) in the elderly patients with hospital-acquired pneumonia (HAP) to provide the basis for formulating prevention and control strategies. Methods A retrospective survey was conducted among 82 elderly HAP patients admitted to the Department of Internal Medicine of Joint Service Support Force Hospital No.904 from January 2018 to December 2019. Deep sputum specimens were collected for bacterial isolation and culture. The patients were divided into MDROs group (n=42) and non-MDROs group (n=40). Distribution and clinical characteristics of MDROs specimens were analyzed. The two groups were compared in clinical indicators, and analysis was performed for the risk factors of MDROs infection. SPSS statistics 22.0 was used for data processing. Depending on data type, t-test or χ² test was performed for comparison between groups, and multivariate unconditional logistic regression for investigation of independent risk factors of MDROs infection. Results Infections by pseudomonas aeruginosa and acinetobacter baumannii were more common in MDROs group. Incidence and mortality of ventilator-associated pneumonia were higher in MDROs group than in non-MDROs group. Multivariate unconditional logistic regression showed that age (OR=1.147,95%CI 1.029－1.279;P=0.013), long hospital stay (OR=1.139,95%CI 1.049－1.238;P=0.002), long antibiotic use (OR=1.081,95%CI 1.014－1.153;P=0.017), prolonged use of the invasive ventilator (OR=1.172,95%CI 1.029－1.334;P=0.016), and C-reactive protein (CRP) (OR=1.144,95%CI 1.047－1.250;P=0.003)were independent risk factors of MDROs infection. Conclusion Pseudomonas aeruginosa and acinetobacter baumannii are common pathogens in the elderly patients with hospital-acquired pneumonia with high incidence and mortality rate of ventilator-associated pneumonia.