A c c e p t e d M a n u s c r i p tNeisseria gonorrhoeae (N. gonorrhoeae) is a sexually transmitted pathogen popular worldwide with increased trend of resistance to antimicrobial treatment. We conducted this study to trace the antimicrobial susceptibilities of N. gonorrhoeae to penicillin, spectinomycin, ciprofloxacin, azithromycin, cefixime and ceftriaxone in Guangxi. Totally 303 NG isolates were sampled from patients infected with N. gonorrhoeae from five cities in Guangxi 2013-2015, and the antibiotic susceptibilities were tested by Agar dilution assay. The results showed that N. gonorrhoeae was susceptible to cephalosporins treatment including ceftriaxone (99.7%), cefixime (99%), spectinomycin (100%), and azithromycin (96.4%), and it was the first report of antibiotic susceptibilities for azithromycin surveillance to N. gonorrhoeae in Guangxi. PPNG with percentage rose from 37% in 2013 to 64% in 2015 (P=0.068), and TRNG rate increased from 23% in 2013 to 44% in 2015 (P = 0.071). High resistance of N. gonorrhoeae to penicillin was associated with infection age of 25 to 30 years (P<0.05) and PPNG positive (P<0.01), and TRNG positive was risk factor for ciprofloxacin resistance (P=0.0407). Our study provides creditable evidences for clinical therapeutic strategies and N. gonorrhoeae infection control and prevention in Guangxi, China.