Objective To analyze the pathogen detection results of patients with acute exacerbation of idiopathic pulmonary fibrosis (AE-IPF) in a hospital in Hainan area, so as to provide basis for diagnosis and treatment of AE-IPF patients. Methods Patients who were with AE-IPF and admitted to a hospital in Hainan Province from January 2016 to December 2019 were retrospectively analyzed, detection results of IgM antibody of respiratory virus, sputum bacterial culture, and atypical pathogen nucleic acid were analyzed, difference in clinical data between pathogen-positive group and pathogen-negative group were compared. Results A total of 52 patients with AE-IPF were analyzed, including 23 cases in pathogen-positive group and 29 in pathogen-negative group. The proportion of patients with fever, purulent sputum and anti-infection treatment, as well as white blood cells, neutrophils and procalcitonin were higher in pathogen-positive group, proportion of patients receiving glucocorticoid treatment was higher in pathogen-negative group, differences were all statistically significant (all P<0.05). There was no significant diffe-rence in mortality between two groups of patients (P>0.05). In patients in pathogen-positive group, 15, 10, and 9 cases were with positive sputum culture, virus IgM, and atypical pathogen nucleic acid respectively, Pseudomonas aeruginosa was most frequently detected pathogen in sputum culture (n=5, 14.7%), respiratory syncytial virus (RSV) and adenovirus (ADV) were the most common virus in positive IgM detection (n=3, both 8.8%), Mycoplasma pneumoniae was the most common pathogen in positire detection of atypical pathogen nucleic acid (n=6, 17.7%). Conclusion Infection may be an important cause of patients with AE-IPF in this hospital in Hainan area, clinical manifestations and inflammatory markers is conductive to indicating the cause of infection in AE-IPF patients.