Acinetobacter species are aerobic, glucose non-fermenting gram-negative rods, and ubiquitous in the environment. Acinetobacter spp. can survive for months on dry surfaces. Acinetobacter spp. have been grown from skin, pharynx, sputum, urine and feces. The most common Acinetobacter infection is pneumonia. According to Japan Nosocomial Infection Surveillance, 0.34% of the Acinetobacter spp. was multidrug-resistant in 2010. In Japan, Acinetobacter spp. whose imipenem MICs were > or = 16 microg/mL, amikacin > or = 32 microg/mL, and ciprofloxacin > or = 4 microg/mL were defined as multidrug-resistant Acinetobacter species (MDRA) in 2011 in the amended Infectious Diseases Control Law. Break-point Checkerboard Plate can help to infer an effective combination antimicrobial therapy. A selective medium for the isolation of MDRA is a great tool for active surveillance cultures. Treatment options for MDRA infections in Japan are very limited, because colistin, polymyxin B, or tigecycline is not approved. Keys to control MDRA are high levels of compliance with standard and contact precautions, appropriate cleaning and disinfection of the environment, and judicious antimicrobial use.