Objective To understand the clinical characteristics, treatment and prognosis of patients with infective endocarditis (IE), and provide reference for the early diagnosis and treatment of IE. Methods Clinical data, isolated pathogens, treatment and prognosis of patients with IE diagnosed in Xiangya Hospital from January 2009 to December 2009 were analyzed retrospectively. Results A total of 430 patients who met the diagnostic criteria of IE were included, most of them were males (n=289, 67.2%). The average age was (40.3±15.1) years. 284 patients (66.0%) had no underlying heart disease, 146 (34.0%) had underlying heart disease, 115 (26.7%) had congenital heart disease, 23 (5.3%) had rheumatic heart disease, and 8 (1.9%) had non-rheumatic heart valve disease. The main clinical manifestations of IE were fever (n=336, 78.1%), anemia (n=381, 88.6%) and heart murmur (n=383, 89.1%); the most common complication was embolism (21.4%), followed by heart failure (18.8%). There were 151 cases of valve prolapse, 88 cases of valve stenosis, 347 cases of valve insufficiency, mostly were aortic valve insufficiency (n=134), 72 cases were with two or more valve insufficiency; positive rate of blood culture was 44.9%, Streptococcus spp.was the most common pathogen (119 strains, 61.7%), followed by Staphylococcus spp., (41 strains, 21.2%). 319 patients (74.2%) with IE were operated, mortality was 10.2%, the recovery rate of patients receiving drug therapy combined with surgery was higher than that of patients only receiving drug therapy(95.3% vs 64.9%,P<0.001). Conclusion At present, IE is common in patients with underlying heart disease, the most common pathogen is Streptococcus spp., anti-infective treatment is the basis of IE treatment, early surgery can reduce the in-hospital mortality.