Objective To understand the distribution and drug resistance of pathogens from urine specimens of older male patients, and provide reference for treatment of infection. Methods Older male outpatients and inpatients with urinary tract infection(UTI) in Wuxi People's Hospital from January 2012 to December 2016 were selected as the research objects, distribution and drug resistance of pathogens of UTI was analyzed. Results A total of 2 745 strains of pathogens were collected, the departments with high positive rate of specimens were intensive care unit(ICU), department of urology, and department of endocrinology, positive rate were 52.75%, 48.70%, and 43.63% respectively. 1 377 strains (50.16%) were Gram-negative bacteria, 814 strains (29.65%) were Gram-positive bacteria, and 554 strains (20.19%) were fungi. The top 5 isolated strains were Escherichia coli (E. coli, n=487, 17.74%), Enterococcus faecium (E. faecium, n=256, 9.33%), Pseudomonas aeruginosa (P. aeruginosa, n=253, 9.22%), Candida albicans (C. albicans, n=250, 9.11%), and Enterococcus faecalis (E. faecalis, n=216, 7.87%). E. coli (n=115, 23.52%), P. aeruginosa (n=88, 35.06%), and E. faecalis (n=77, 35.65%) were the most detected strains in department of urology. E. faecalis (n=38, 14.84%) and C. albicans (n=83, 33.20%) were the most detected strains in ICU. Resistance rates of E. coli, Klebsiella pneumoniae (K. pneumo-niae), and P. aeruginosa to imipenem were 1.23%, 5.59%, and 15.02% respectively; resistance rates of E. coli to piperacillin/tazobactam, amikacin, and furantoin were 3.49%, 6.16%, and 8.62% respectively; resistance rates of K. pneumoniae to cefepime, ceftazidime, and piperacillin/tazobactam were 23.78%, 16.78%, and 12.59% respectively. Resistance rates of E. faecium to vancomycin and linezolid were 4.30% and 4.69% respectively; resistance rates of E. faecalis to vancomycin, linezolid, and ampicillin were 0.46%, 2.78%, and 3.24% respectively. A total of 38 strains of carbapenem-resistant P. aeruginosa were isolated, there was increased trend in the number of strains year by year. Conclusion The main pathogens causing UTI in older male patients is E. coli, which is sensitive to imipenem, piperacillin/tazobactam, amikacin, and furantoin. Distribution of the top 5 pathogens in departments of older male patients with UTI is different, clinical empirical therapy should consider department distribution and antimicrobial resistance characteristics of pathogens of older male patients with UTI, so as to select antimicrobial agents rationally.