Objective To explore risk factors for healthcare-associated pneumonia (HAP) caused by carbapenem-resistant Enterobacter cloacae (CREC) in patients in intensive care unit (ICU). Methods From July 2013 to June 2017, 64 patients with CREC-HAP in ICU of a hospital were collected as case group, and 64 patients with carbape-nem-sensitive Enterobacter cloacae HAP (CSEC-HAP) were as control group, risk factors for the occurrence of CREC-HAP were analyzed retrospectively by 1:1 matched case-control study. Results Univariate analysis showed that APACHE Ⅱ score ≥ 20, long length of ICU stay, use of ventilator, long length of ventilator use, use of carbapenems, long duration of antimicrobial use, and at least 2 kinds of antimicrobial agents combined use were associated with the occurrence of CREC-HAP (all P<0.05). Multivariate logistic regression analysis showed that APACHE Ⅱ score ≥ 20, use of ventilator, long length of ventilator use, use of carbapenems, and long duration of antimicrobial use were independent risk factors for occurrence of CREC-HAP (all P<0.05). Conclusion Risk factors for occurrence of CREC-HAP in ICU patients include the use of carbapenems, long length of ventilator use, long duration of antimicrobial use, and APACHE Ⅱ score ≥ 20. Effective preventive and control measures can be formulated and taken in view of the above risk factors.