OBJECTIVE: To study the clinical features, distribution of pathogens, drug susceptibility, and treatment effectiveness in neonates with urinary tract infection (UTI) and admitted to the neonatal intensive care unit (NICU). METHODS: The clinical data of 229 neonates who developed UTI during their stay in the NICU were retrospectively studied. RESULTS: The main clinical manifestations of these children included fever/irregular body temperature, refusing to milk feeding, jaundice, vomiting, diarrhea, poor weight gain, and lethargy. The top three pathogens were Escherichia coli, Enterococcus feces, and Klebsiella pneumoniae. Escherichia coli and Klebsiella pneumoniae were highly resistant to ampicillin and most cephalosporins (≥85%), and were highly sensitive to imipenem (100%), meropenem (100%), cefoperazone/sulbactam and piperacillin/tazobactam (>90%). Enterococcus feces were highly resistant to penicillin (100%), rifampicin (84%). and gentamicin (79%), but were sensitive to vancomycin. CONCLUSIONS: The clinical manifestations of neonatal UTI are often atypical and manifested as systemic symptoms. The main pathogenic bacterium is Escherichia coli, and the isolation rate of enterococci can also be high. Most pathogenic bacteria are resistant to penicillin and cephalosporins, and therefore decision-making on drug administration must be based on the results of drug sensitivity tests.