Background: Due to the difficulty of treatment caused by its numerous mechanisms of resistance, only four kinds of antibiotics are recommended for the therapy of Stenotrophomonas maltophilia infections associated with significant morbidity and mortality. Objectives: In this four-year study, we aimed to determine the evolution of drug resistance to S. maltophilia base on drug classification guidelines recommended by the Institute of Clinical and Laboratory Standards. Methods: A total of 1876 strains of S. maltophilia was separated from multifarious clinical specimens among January 2016 and December 2019. VITEK 2 Compact microbial system was used for speciation level identification and antibiotic sensitivity test. Results: A total of 1876 strains of S. maltophilia strains were separated from sputum specimen type (70.63%), Followed by bronchial (6.18%), blood (4.16%), and bronchoalveolar lavage samples (4.32%). Moreover, 695 strains of S. maltophilia strains were separated from intensive care unit (ICU) department (37.05%), and then neurosurgery ward (10.66%), integrative Chinese and western medicine ward (7.25%), general surgery ward (6.66%). The results of minocycline antibiotic of S. maltophilia with a drug resistance rate of 0.3%. From 2016 to 2019, the resistance rate of cefoperazone/sulbactam decreased from 20.8% to 15.2%, the resistance rate of trimethoprimsulfametoxasole decreased from 7.9% to 4.5%. The resistance rate of minocycline fluctuate in 0.0%% between 0.7%. However, the resistance rate of levofloxacin increased from 7.7% to 8.0%. Conclusions: In this study, S. maltophilia was detected in a variety of specimen types of different clinical departments, with the most detected in ICU patients and sputum specimen. S. maltophilia was sensitive to minocycline and levofloxacin, but the situation of cefoperazone/sulbactam resistance was not optimistic. The results of this study indicate that minocycline is considered to be the most effective antibiotic for the treatment of S. maltophilia. Therefore, we still need to strengthen the drug resistance monitoring, timely acquisition of S. maltophilia drug resistance changes, and actively take effective measures to deal with the drug resistance of S. maltophilia.