Objective To investigate the distribution and antimicrobial susceptibility of clinically isolated bacteria from intensive care units (ICUs) in hospitals of Hunan Province Antimicrobial Resistance Surveillance System from 2012 to 2021. Methods According to China Antimicrobial Resistance Surveillance System, data of clinically isolated bacterial strains and antimicrobial susceptibility testing results of bacteria from ICUs reported by all member units of Hunan Province Antimicrobial Resistance Surveillance System were analyzed with WHONET 2022 software. Results From 2012 to 2021, the total number of bacteria isolated from ICUs of member units of the Hunan Province Antimicrobial Resistance Surveillance System was 5 777-22 369, with Gram-negative bacteria accounting for 76.1%-78.0% annually. Staphylococcus aureus ranked first among isolated Gram-positive bacteria each year. The top 5 bacteria among Gram-negative bacteria were Acinetobacter baumannii, Klebsiella pneumoniae, Escherichia coli, Pseudomonas aeruginosa, and Stenotrophomonas maltophilia. Detection rate of methicillin-resistant Staphylococcus aureus showed a downward trend year by year. No Staphylococcus spp. were found to be resistant to vancomycin, teicoplanin and linezolid. Detection rates of vancomycin-resistant Enterococcus faecalis and vancomycin-resistant Enterococcus faecium were 0.6-1.1% and 0.6%-2.2%, respectively. Resistance rates of Escherichia coli and Klebsiella pneumoniae to imipenem were 3.1%-5.7% and 7.7%-20.9%, respectively. Resistance rates of Pseudomonas aeruginosa and Acinetobacter baumannii to imipenem were 24.6%-40.1% and 76.1%-80.9%, respectively. Detection rates of carbapenem-resistant Pseudomonas aeruginosa declined year by year. Acinetobacter baumannii maintained high susceptibility to polymyxin B, with resistance rate ＜10%. Conclusion Antimicrobial resistance of bacteria from ICUs is serious. Carbapenem-resistant Enterobacteriales has an upward trend after 2019. It is nece-ssary to strengthen the surveillance of bacterial resistance and carry out multidisciplinary collaboration.