Objective To understand the distribution and antimicrobial resistance of bacteria from traditional Chinese medicine hospitals in China from 2022 to 2024, and provide reference for the rational use of antimicrobial agents in clinical practice. Methods Surveillance data of bacteria and antimicrobial susceptibility testing results were co-llected from traditional Chinese medicine hospitals as member units of China Antimicrobial Resistance Surveillance System (CARSS) from 2022 to 2024. Only the first strain of the same bacteria from the same patient was included in the analysis. Statistical analysis was conducted using WHONET 5.6 software. Results From 2022 to 2024, a total of 1 491 099 bacterial strains were included in the analysis. The top 4 isolated bacteria were Escherichia coli, Klebsiella pneumoniae, Pseudomonas aeruginosa, and Staphylococcus aureus. Analysis showed that the detection rates of Klebsiella pneumoniae and Staphylococcus aureus were on the rise, while those of Escherichia coli and Pseudomonas aeruginosa were on the decline. The top 4 types of specimens were sputum, urine, pus, and blood. Antimicrobial susceptibility testing results showed that the resistance rate of Gram-negative bacteria to piperacillin/tazobactam has generally increased, with Pseudomonas aeruginosa increasing from 12.0% to 16.5%. The resis-tance rates of the main pathogenic bacteria to most third-generation cephalosporins presented decreased trends. The resistance rate of Klebsiella pneumoniae to cefotaxime has decreased from 30.3% to 27.0%. The detection rate of vancomycin-resistant Enterococcus faecium (VREM) increased from 2.8% to 4.3%, and the detection rate of carbapenem-resistant Escherichia coli (CRECO) increased from 1.9% to 2.1%. Compared with the overall data nationwide (taking 2023 as an example), the detection rates of CRECO (2.1% vs 1.7%) and carbapenem-resistant Pseudomonas aeruginosa (CRPAE, 19.5% vs 16.3%) from specimens from traditional Chinese medicine hospitals were higher, while the detection rates of carbapenem-resistant Acinetobacter baumannii (CRABA, 49.4% vs 55.5%) and cefotaxime- or ceftriaxone-resistant Escherichia coli (CTX/CRO-R ECO) (46.4% vs 48.9%) were lower. Conclusion The constituent of bacteria isolated from traditional Chinese medicine hospitals in China is relatively stable. Attentions should be paid to the increased detection rates of VREM and CRECO, and the management of antimicrobial agents should be strengthened further.