Antimicrobial resistance (AMR) in clinical bacterial isolates in China has been extensively studied through national surveillance systems such as CHINET and CARSS, established in 2005. These systems monitor the resistance profiles of Gram-negative bacilli and Gram-positive cocci, with Gram-negative bacilli showing higher resistance rates. The prevalence of ESBLs in E. coli is around 50%, and carbapenem resistance in Acinetobacter baumannii-calcoaceticus complex (ABC) is approximately 66%, though this has decreased since 2018. Vancomycin-resistant Enterococcus (VRE) and methicillin-resistant Staphylococcus aureus (MRSA) have shown decreasing trends. Carbapenem-resistant Klebsiella pneumoniae (CRKP) prevalence increased from 2.9% in 2005 to 25.0% in 2018, then slightly decreased to 22.6% in 2022. The decrease in CRKP is attributed to antimicrobial stewardship efforts. The resistance profile of ABC has shown an increasing trend, with carbapenem resistance rates varying by province. The prevalence of MRSA has decreased from 69.0% in 2005 to 28.7% in 2022, but increased in children. The prevalence of VRE is low, with less than 5% for E. faecium and less than 1% for E. faecalis. Pseudomonas aeruginosa has shown a decreasing resistance trend, with carbapenem-resistant P. aeruginosa (CRPA) prevalence ranging from 7.6% to 26%. The main resistance mechanisms in Gram-negative bacilli include carbapenemases such as NDM-1, KPC-2, and VIM-2. In Gram-positive cocci, MRSA prevalence has decreased, but there is concern about increasing trends in children. The review highlights the importance of continued surveillance and antimicrobial stewardship to address AMR challenges in China. The study has some limitations, including potential variability in data comparability due to increasing surveillance network members and lack of detailed statistical analysis. Future efforts should focus on monitoring trends in carbapenem-resistant organisms and understanding the factors contributing to increasing MRSA prevalence in children.Antimicrobial resistance (AMR) in clinical bacterial isolates in China has been extensively studied through national surveillance systems such as CHINET and CARSS, established in 2005. These systems monitor the resistance profiles of Gram-negative bacilli and Gram-positive cocci, with Gram-negative bacilli showing higher resistance rates. The prevalence of ESBLs in E. coli is around 50%, and carbapenem resistance in Acinetobacter baumannii-calcoaceticus complex (ABC) is approximately 66%, though this has decreased since 2018. Vancomycin-resistant Enterococcus (VRE) and methicillin-resistant Staphylococcus aureus (MRSA) have shown decreasing trends. Carbapenem-resistant Klebsiella pneumoniae (CRKP) prevalence increased from 2.9% in 2005 to 25.0% in 2018, then slightly decreased to 22.6% in 2022. The decrease in CRKP is attributed to antimicrobial stewardship efforts. The resistance profile of ABC has shown an increasing trend, with carbapenem resistance rates varying by province. The prevalence of MRSA has decreased from 69.0% in 2005 to 28.7% in 2022, but increased in children. The prevalence of VRE is low, with less than 5% for E. faecium and less than 1% for E. faecalis. Pseudomonas aeruginosa has shown a decreasing resistance trend, with carbapenem-resistant P. aeruginosa (CRPA) prevalence ranging from 7.6% to 26%. The main resistance mechanisms in Gram-negative bacilli include carbapenemases such as NDM-1, KPC-2, and VIM-2. In Gram-positive cocci, MRSA prevalence has decreased, but there is concern about increasing trends in children. The review highlights the importance of continued surveillance and antimicrobial stewardship to address AMR challenges in China. The study has some limitations, including potential variability in data comparability due to increasing surveillance network members and lack of detailed statistical analysis. Future efforts should focus on monitoring trends in carbapenem-resistant organisms and understanding the factors contributing to increasing MRSA prevalence in children.