Objective To analyse the distribution characteristics and drug resistance of multidrug-resistant bacteria infections in patients with diabetic foot ulcers, and to investigate the relevant risk factors affecting the infection of multidrug-resistant bacteria in patients with diabetic foot ulcers. Methods We selected 352 patients with diabetic foot ulcers admitted to our hospital from January 2021 to December 2023, and retrospectively collated and analysed the clinical data of all patients, collected the ulcer wound specimens of all patients, analysed the infection of multidrug-resistant bacteria and bacterial resistance, compared the differences in the relevant data of patients with different infections, and analysed the risk factors affecting the patients with diabetic foot ulcers by using multivariate logistic regression model. Multiple logistic regression model was used to analyse the risk factors affecting patients with diabetic foot ulcers infected with multi-drug resistant bacteria. Results A total of 352 patients with diabetic foot ulcers, 20.45% developed multidrug-resistant bacterial infections, and a total of 91 strains of bacteria were detected, with the predominant strains being Staphylococcus aureus (41.76%), Pseudomonas aeruginosa (24.18%) and Enterobacteriaceae (21.98%).Compared with uninfected patients, patients with MDRI had a longer duration of diabetes, longer duration of ulcers, a higher proportion of Wagner grade 3-5, ischaemic ulcers, multiple hospitalisations, combined osteomyelitis, larger ulcers, and a longer duration of antibiotic use (P < 0.05).Multifactorial analysis showed that long duration of diabetes mellitus, high Wagner grading, long duration of ulcer, large ulcer size, multiple hospitalisations, prolonged antibiotic use, and comorbid osteomyelitis were all risk factors for MDRI (P < 0.05). Conclusion Patients with diabetic foot ulcers are at risk of multi-resistant bacterial infections, and longer duration of diabetes mellitus, Wagner grade 3-5, longer duration of ulcers prior to hospitalisation, larger ulcer size, hospitalisation for the same wound >2 times/year, prolonged use of antibiotics prior to hospitalisation, and comorbidity with osteomyelitis can increase the risk of multi-resistant bacterial infections in patients with diabetic foot ulcers, therefore, controlling and reducing multi-resistant bacterial infections is the key to improving the prognosis of patients with diabetic foot ulcers.