Objective To understand the species distribution and antimicrobial resistance characteristics of pathogenic bacteria isolated from patients in department of neurology in China, and provide a basis for the prevention and control of healthcare-associated infection as well as the rational use of antimicrobial agents in clinical. Methods Bacterial resistance monitoring data of patients in department of neurology in member units of China Antimicrobial Resistance Surveillance System in 2021 were selected, and analyzed with WHONET 5.6 software. Results In 2021, a total of 127 506 strains of bacteria were isolated from patients in department of neurology. Gram-positive bacteria and Gram-negative bacteria accounted for 21.6% (n=27 526) and 78.4% (n=99 980), respectively. The major specimens were sputum (n=67 782, 53.2%), urine(n=37 789, 29.6%)and blood (n=10 599, 8.3%). Isolation rates of methicillin-resistant Staphylococcus aureus (MRSA) and methicillin-resistant coagulase negative Staphylococcus (MRCNS) were 31.9% and 66.4%, respectively. No Staphylococcus strains were found to be resistant to vancomycin and teicoplanin. Resistance rates of Enterococcus faecalis and Enterococcus faecium to vancomycin were 0.4% and 1.7%, respectively. Among Enterobacterales, resistance rates of Klebsiella pneumoniae to imipenem and meropenem were 9.8% and 11.4%, which were higher than those of Escherichia coli (1.2% and 1.3%, respectively). Acinetobacter baumannii had a high resistance rate to carbapenems, with resistance rates to imipenem and meropenem being 52.0% and 54.4%, respectively. Conclusion Bacteria isolated from patients in department of neurology are mainly Gram-negative bacteria, mostly from lower respiratory tract specimens. Antimicrobial resistance of the frequently clinically isolated bacteria is severe. Cntinuous monitoring on bacterial resistance should be carried out to promote the rational use of antimicrobial agents.