OBJECTIVE： To observe therapeutic efficacy and safety of cefoperazone sodium and sulbactam sodium combined with Shenmai injection in the treatment of elderly stroke associated pneumonia （SAP）. METHODS： A total of 84 SAP patients in Dazhou Municipal Central Hospital during Mar. 2016-Mar. 2017 were divided into control group （42 cases） and observation group （42 cases） according to random number table. Based on routine treatment， control group was additionally given Cefoperazone sodium and sulbactam sodium for injection 3 g added into 5％ Glucose injection 100 mL， intravenously， twice a day； suitable antibiotics were selected according to the results of pathogenic examination and drug sensitivity test. Observation group was additionally given Shenmai injection 100 mL added into 5％ Glucose injection 250 mL intravenously， once a day， on the basis of control group. Both groups were treated for consecutive 2 weeks. Clinical efficacies of 2 groups were observed， and the levels of T-lymphocyte subsets （CD4+， CD8+， CD4+/CD8+） and inflammatory markers （TNF-α， hs-CRP， PCT）， length of hospital stay before and after treatment. The ADR was recorded. RESULTS： The total response rate （95.24％） and marked response rate （47.62％） of observation group were significantly higher than those of control group （83.33％， 23.81％）； length of hospital stay in observation group [（15.24±3.53）d] was significantly shorter than control group [（18.43±4.21）d]， with statistical significance （P＜0.05）. After treatment， the levels of CD4+ and CD4+/CD8+ in 2 groups were significantly higher than before treatment， and the observation group was significantly higher than the control group； the levels of CD8+， TNF-α， hs-CRP and PCT in 2 groups were significantly lower than before treatment； the observation group was significantly lower than the control group， with statistical significance （P＜0.05）； there was no statistical significance in the incidence of ADR between 2 groups （P＞0.05）. CONCLUSIONS： Based on routine treatment， cefoperazone sodium and sulbactam sodium combined with Shenmai injection treat SAP significantly， can effectively improve immune function， reduce inflammation level and shorten the length of hospital stay without increasing the occurrence of ADR.