Abstract: Objective To evaluate the distribution characteristics and drug resistance of Streptococcus pneumoniae infection in child patients within Suqian area. Methods A retrospective analysis was performed using clinical data from child patients who was admitted in the Affiliated Suqian Hospital of Xuzhou Medical University due to Streptococcus pneumoniae infection from January 2017 to December 2019. Their general information was collected and the characteristics of the samples and drug sensitivity were analyzed. Results A total of 3 239 strains of pathogens were isolated from the patients, including 562 strains of Streptococcus pneumonia in which 357 strains (63.52%) of Streptococcus pneumoniae was isolated from boys. With a higher positive rate in children under three years old(87.9%).The samples were mainly from the sputum, blood, bronchoalveolar lavage fluid, et al, where 444 strains (79.00%) of Streptococcus pneumoniae were isolated from the sputum. The patients may be also co-infected with Haemophilus influenzae, respiratory syncytial virus, influenza virus, Mycoplasma pneumoniae or adenovirus, where the infection rate of Streptococcus pneumoniae combined with respiratory syncytial virus was high (14.59%). Streptococcus pneumoniae was more sensitive to amoxicillin, ertapenem, ofloxacin, levofloxacin, moxifloxacin, telithromycin, linezolid, vancomycin and chloramphenicol (92.95%-100%), with high drug resistance to erythromycin, tetracycline and compound neonomine (73.65%-99.43%). Conclusions Streptococcus pneumoniae mainly infects children under three-year-old through the respiratory tract, especially for boys. Meanwhile, some of the patients were also infected with other pathogens in addition to Streptococcus pneumoniae. For child patients with Streptococcus pneumoniae infection in Suqian area, the first choice is amoxicillin, the third generation cephalosporins or penicillin.