Objective To investigate the distribution and antimicrobial resistance of pathogens isolated from fecal specimens in China. Methods Relevant data of fecal specimens (excluding intestinal normal colonized bacteria) were extracted from surveillance report of China Antimicrobial Resistance Surveillance System (CARSS) in 2014-2019, changes of intestinal pathogenic bacteria and antimicrobial resistance rates in the past 6 years were analyzed. Results A total of 61 809 strains were isolated, the top 3 were Salmonella spp. (82.12%), Shigella spp. (8.08%) and Vibrio spp. (4.03%), Salmonella spp. accounted for more than 70% of pathogenic bacteria in fecal specimens each year, with the highest proportion of 87.16% in 2018. In the past 6 years, there was no change in the top 6 pathogenic bacteria strains, only constituent ratios of bacterial species changed slightly each year, Salmonella spp. showed an upward trend, while Shigella spp. showed a downward trend. The major bacteria were unclassified species of Salmonella (49.39%), Shigella flexneri (46.64%), Vibrio parahaemolyticus (91.20%), Aeromonas hydrophila (55.80%) and enteropathogenic Escherichia coli (85.02%). Resistance rate of enteropathogenic bacteria to ampicillin was high, Shigella spp. and diarrheagenic Escherichia coli (>90%) were higher than Salmonella spp. and Vibrio spp. Resistance rate of Salmonella to levofloxacin was low, but show a rising trend, which increased from less than 3% to about 10%; resistance rate of Shigella spp. to ciprofloxacin was low (29.9%) in 2016; resistance rates of Vibrio spp. to antimicrobial agents (except ampicillin) were low (<6%); carbapenem-resistant Aeromonas spp. strains emerged, resistance rates of Aeromonas spp. and diarrheagenic Escherichia coli to amikacin were both low. Conclusion There are multiple species of pathogenic bacteria causing bacterial diarrhea, mainly Salmonella spp. and Shigella spp., antimicrobial resistance is serious, different bacterial species and strains vary significantly, it is necessary to continue to strengthen the management of rational application of antimicrobial agents as well as prevention and control of healthcare -associated infection, and do a good job in the surveillance of antimicrobial-resistant bacteria.