Objective To understand the difference in economic loss between carbapenem-resistant Acinetobacter baumannii(CRAB) and carbapenem-susceptible Acinetobacter baumannii(CSAB) healthcare-associated infection(HAI), and improve health care workers' awareness on the prevention and control of CRAB infection. Methods Patients with Acinetobacter baumannii infection in the intensive acre unit(ICU) of a tertiary first-class hospital from October 2012 to September 2018 were studied and divided into CRAB group and CSAB group according to susceptibility of Acinetobacter baumannii to carbapenems, two groups were matched according to 1:1 matching standard, paired rank sum test was used to analyze the direct economic loss of two groups of patients. Results Forty-six pairs were matched, the median hospitalization expense of CRAB group and CSAB were 179 192 yuan and 82 314 yuan respectively, difference between two groups was 96 878 yuan; the median length of hospital stay of CRAB group and CSAB group were 49 days and 27 days respectively, difference between two groups was 22 days; difference in total hospitalization expense and length of hospital stay between two groups were both significant (both P<0.05). The main direct economic loss of patients with CRAB HAI were western medicine fee (29 246 yuan), material fee (19 465 yuan) and treatment fee (12 872 yuan), accounting for 63.6% of direct economic loss. Conclusion CRAB HAI can lead to prolonged length of hospital stay and increase hospitalization expense, so it is essential to reduce the incidence of CRAB HAI.