Abstract: Objective To understand the distribution of pathogens and the drug resistance of Escherichia coli in liver cirrhosis patients complicated with spontaneous bacterial peritonitis (SBP) and provide evidence for the clinical diagnosis and treatment of SBP. Methods Totally 115 hospitalized liver cirrhosis patients complicated with SBP in our hospital from January 2006 to December 2010 were selected to conduct pathogen isolation from ascites samples and drug susceptibility test of pathogens isolated. Results Totally 115 strains of 18 pathogens were isolated from the patients ascites samples. The detection rate of E. coli was highest (47.0%), and 19 strains of E. coli were ESBLs producing (35.2%). E. coli was sensitive to carbapenems antibiotics, but the resistance to -lactam antibiotics showed an increase trend. Conclusion The diagnosis of SBP should depend on both pathogen isolation result and clinical symptoms. Antibiotics should be used according to the result of drug susceptibility test.