OBJECTIVE： To observe clinical efficacy and safety of tigecycline combined with isepamicin in the treatment of multidrug-resistant Acinetobacter baumannii pneumonia.  METHODS： 70 patients diagnosed as multidrug-resistant A. baumannii pneumonia were selected and randomly divided into control group and observation group， with 35 cases in each group. Both groups received routine treatment oxygen therapy or mechanical ventilation， anti-hypertension， hypoglycemic therapy. Control group was given Cefoperazone sulbactam for injection 3 g added into Sodium chloride injection 100 ml， ivgtt， qid. Observation group received Tigecycline for injection 100 mg， decreasing to 50 mg added into Sodium chloride injection 250 ml， ivgtt， bid， combined with Isepamicin sulfate injection 400 mg added into Sodium chloride injection 250 ml， ivgtt， qd. The time of body temperature return to normal， pulmonary rale disappearance， chest X-ray shadow disappearance and leucocyte return to normal were observed in 2 groups as well as serum inflammatory factor level before and after treatment； total effective rate， bacterial clearance rate and ADR were compared between 2 groups. RESULTS： The time of body temperature return to normal， pulmonary rale disappearance， chest X-ray shadow disappearance and leucocyte return to normal in observation group were significantly shorter than in control group， with statistical significance （P＜0.05）. There was no statistical significance in serum inflammatory factor between 2 groups before treatment （P＞0.05）. The serum inflammatory factor of 2 groups decreased significantly after treatment， and the observation group was significantly lower than the control group， with statistical significance （P＜0.05）. Total effective rate and effective bacterial clearance rate of observation group were 85.7％ and 82.9％， which were significantly higher than those of control group （62.9％ and 60.0％）， with statistical significance （P＜0.05）. There was no statistical significance in the incidence of ADR between 2 groups （P＞0.05）. CONCLUSIONS： Tigecycline combined with isepamicin is effective for multidrug-resistant A. baumannii pneumonia， and can improve clinical symptom， control inflammation reaction， having high sterilization with good safety.