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To observe the pathogenic bacteria distribution and drug resistance in neonatal necrotizing enterocolitis（NEC）, and to analyze the influencing factors of the incidence of NEC children. Methods: 50 NEC children who were treated in our hospital from August 2016 to September 2020 were selected（NEC group）, and 100 cases of healthy newborns received in our hospital during the same period as the control group, the pathogenic bacteria distribution and drug resistance in NEC children were observed, and the influencing factors of the incidence of NEC children were analyzed. Results: A total of 63 strains of pathogenic bacteria were isolated from 50 cases of NEC children. There were 38 strains of Gram-negative bacteria, accounting for 60.32%, 23 strains of Gram-positive bacteria, accounting for 36.51%, and 2 strains of fungi, accounting for 3.17%. Escherichia coli and Klebsiella pneumoniae were all less sensitive to ofloxacin, cefoperazone, ceftazidime, cefazolin, amoxicillin, ampicillin, ciprofloxacin and ceftriaxone, and they had highly sensitive to imipenem/cestastatin, piperacillin/tazobactam, meropenem and polymyxin. Univariate analysis showed that the incidence of NEC was associated with neonatal weight, breast-feeding, prenatal use of glucocorticoids, gestational diabetes mellitus, gestational hypertension, neonatal Apgar score, whether combined with pulmonary infection and combined with sepsis（P<0.050. Multivariate logistic regression analysis showed that breast-feeding was the protective factor of the incidence of NEC, and combined with sepsis, gestational diabetes mellitus, neonatal weight, combined with pulmonary infection and neonatal Apgar score were the risk factors of the incidence of NEC（P<0.05), Conclusion: Gram negative bacteria are the main pathogens of NEC. At the same time, there are many factors that affect the incidence of the incidence of NEC, so targeted intervention or treatment measures should be developed in combination with relevant influencing factors to reduce the risk of the incidence of NEC. [ABSTRACT FROM AUTHOR]