Objective To investigate the change in antimicrobial resistance of all Klebsiella spp. and Klebsiella spp. isolated from pediatric patients in Hunan Province, provide evidence for rational use of antimicrobial agents in the medical institutions in this area. Methods Data about Klebsiella spp. from Hunan Province Antimicrobial Resistance Surveillance System in 2012-2021 were analyzed, and the results were judged according to M100 32nd edition standard of American Clinical and Laboratory Standards Institute (CLSI), WHONET 5.6 software was used to statistically analyze the results. Results A total of 361 539 Klebsiella spp. strains were isolated from hospitals in Hunan Province Antimicrobial Resistance Surveillance System in 2012-2021, Klebsiella pneumoniae accounted for 86.7%, and strains were mainly from respiratory tract specimens (66.5%). The resistance rate of Klebsiella spp. to imipenem and meropenem were about 10.0% in 2015-2021. The resistance rate to tigecycline decreased, with a resistance rate of 7.1% in 2012-2013 and an annual average resistance rate < 4.0% in 2018-2021. The resistance rate of bacteria to cefoperazone/sulbactam increased significantly in 2012-2021, with a rate of 13.3% in 2020-2021. Carbapenems resistance rates of Klebsiella spp. from pediatric patients in 2015-2021 were 3.5%-8.6%, and the resistance rates to tigecycline were all ≤3.8% in 2012-2021. The detection rates of carbapenem-resistant Klebsiella spp. in newborns, children aged 29 days-14 years, adults and elderly patients in 2020-2021 were 4.7%, 3.9%, 9.5% and 10.2%, respectively. Conclusion The resistance rates of Klebsiella spp. to carbapenems were low in 2012-2021, tigecycline-resistant strains have emerged, which should be paid attention to, antimicrobial agents should be used rationally to prevent and control the occurrence of healthcare-associated infection.