Background: Acinetobacter baumannii is an important pathogen in health care associated infections. Objectives: To determine the risk factors and drug resistance from the various samples. Material and Methods: Prospective review based study conducted in referral hospital in Sikkim, India for one year. The samples were identified and their sensitivity determined by VITEK 2. A retrospective chart review was performed to determine the potential risk factors. Results: From 917 isolates, A.baumannii accounted for 158 (17.2%) and was predominantly isolated from sputum 53(18.9%) and pus 73(9.91%) and 109 (68.9%) isolates were from ICU and 49(31%) from ward. The risk factors associated were invasive devices, antibiotics and multiple hospitalizations in past and prolonged ICU stay. A.baumannii were 100% resistant to amoxyclav, ampicillin, and cefuroxime. Higher degrees of resistance were recorded for aminoglycosides, cephalosporins and carbapenems while colistin (5%) and tigecycline (12%) showed lower resistance. Conclusion: Rationalizing the use of antimicrobials should be done, which can be achieved by an effective antimicrobial stewardship program and close monitoring