Abstract: OBJECTIVE To investigate the risk factors and analyses of antibiotic resistance of severe craniocerebral trauma patients with pulmonary infection of Acinetobacter baumannii, to provide references for clinical prevention and treatment. METHODS The clinical data of 55 patients of severe craniocerebral trauma with pulmonary infection of Acinetobacter baumannii as test group, and the same time selected 55 patients of severe craniocerebral trauma with pulmonary infection of no Acinetobacter baumannii as control group from Feb. 2014 to Mar. 2016, were analyzed to investigate related risk factors by univariate χ² analysis and multivariate Logistic analysis. Drug susceptibility of Acinetobacter baumannii to common antimicrobial agents using disk diffusion method. The data were analyzed by SPSS 20.0 software. RESULTS The study showed that low protein hyperlipidemia, GCS score, ICU stays, using penicillium carbon alkene and glucocorticoids were the risk factors for pulmonary infection of Acinetobacter baumannii(P<0.01). The antimicrobial susceptibility testing showed that sensitivity rate of cefoperazone sodium/sulbactam sodium, amikacin and imipenem for acinetobacter baumannii were much higher than others antibacterial drugs, the sensitivity rates respectively were 78.18%, 54.55% and 45.45%, and sensitivity rate of levofloxacin, ampicillin sulbactam and piperacillin sodium tazobactam were <30%. CONCLUSION Low protein hyperlipidemia, GCS score (<8 points), ICU stays (>7 d), using penicillium carbon alkene and glucocorticoids are the risk factors for pulmonary infection of Acinetobacter baumannii. Cefoperazone sulbactam are still the most active agent against Acinetobacter baumannii, followed by amikacin and imipenem. Therapy should be decided according to the results of susceptibility test.