Objective To understand the epidemiology of clinically isolated Acinetobacter baumannii (A. baumannii) in Hunan Province. Methods Bacterial antimicrobial resistance surveillance was carried out according to the requirements of the technical program of National Antimicrobial Resistance Surveillance System. Clinical data of Acinetobacter spp. reported to Hunan Provincial Antimicrobial Resistance Surveillance System by multiple centers in Hunan Province from 2012 to 2021 were summarized and analyzed with reference to the standards of the American Clinical and Laboratory Standards Institute. Results A total of 169 438 strains of Acinetobacter spp. were detected during the 10-year period, with the detection rate of A. baumannii being the highest (82.74%). 70 923 strains (53.63%) of carbapenem-resistant A. baumannii (CRAB) and 58 149 strains (43.97%) of carbapenem-sensitive A. baumannii (CSAB) were detected respectively. Both CRAB and CSAB were detected most frequently in the age group >70 years, which were 34.44% and 32.02%, respectively. The percentage of CRAB and CSAB detected in the intensive care unit were 34.80% and 11.31%, respectively. CRAB and CSAB were mainly isolated from sputum/bronchoalveolar lavage fluid, followed by pus/secretion, urine, and blood. The resistance rates of CRAB to commonly used antimicrobial agents didn't change much during the 10-year period. Resistance rates of CRAB to ceftazidime and cefepime were both >84%, to ampicillin/sulbactam and piperacillin/tazobactam were both >82%, to aminoglycosides and quinolones were both >59%, to minocycline and polymyxin B were 15.9%-25.0% and 1.3%-6.9%, respectively. CSAB were sensitive to commonly used antimicrobial agents. Conclusion The isolation rate of CRAB is high and there is no significant change in resistance to commonly used antimicrobial agents.