Objective To investigate the distribution characteristics of Klebsiella pneumoniae (KP), hypervirulent Klebsiella pneumoniae (hvKP), carbapenem-resistant Klebsiella pneumoniae (CRKP), and hypervirulent carbapenem-resistant Klebsiella pneumoniae (hv-CRKP/CR-hvKP) in the environment of general intensive care unit (ICU) at medical institutions, and provide reference for environment assessment as well as healthcare-associated infection (HAI) prevention and control in ICU. Methods A total of 3 336 environmental specimens were collected from general ICUs of medical institutions in Shanghai in 2019 and 2023. After strain isolation, antimicrobial susceptibility testing and whole genome sequencing were conducted. Results The detection rate of KP was 1.59% (n=53), among which hvKP, CRKP, and hv-CRKP/CR-hvKP accounted for 37.74% (20/53), 52.83% (28/53), and 24.53% (13/53) of the total detected strains, respectively. The main types of hvKP were ST11-KL64 and ST11-KL25, CRKP were ST15-KL19 and ST11-KL25, hv-CRKP/CR-hvKP were ST11-KL25 and ST11-KL64. The main carried resistance genes included fosA, oqxAB, tet(A), bla_TEM-1B, bla_KPC-2, qnrS11, etc. All strains carried virulence genes fimH, iutA, entA, entB, entC, entD, entE, and entF, with only one strain carrying rmpA gene. Conclusion KP contamination is widespread in general ICU environment of medical institutions, predominantly ST11 and ST15, presenting a polymorphic distribution. CRKP and hvKP account for a relatively high proportion, and multidrug resistance is serious. Co-evolution of drug resistance and virulence presents in KP, and poses significant infection and pathogenic risks to patients, necessitating enhanced clinical vigilance and preparedness for potential outbreaks.