In recent years, with the increasing clinical use and intensity of carbapenem antibiotics, the resistance rate of Acinetobacter baumannii to carbapenem antimicrobial agents has shown a gradual upward trend. Carbapenem-resistant Acinetobacter baumannii is now widely distributed globally, with detection rates continuously rising, making it one of the major global public health issues. The resistance mechanisms of carbapenem-resistant Acinetobacter baumannii are complex, involving the production of carbapenemases, overexpression of efflux pumps, deletion or altered expression of outer membrane proteins, biofilm formation, and changes in drug binding sites. For infections caused by multidrug-resistant Acinetobacter baumannii, the number of clinically available antimicrobial agents is diminishing, making infection control challenging and resulting in high patient mortality rates. Therefore, clinicians should actively prevent multidrug-resistant Acinetobacter baumannii, optimize antimicrobial use and infection control, and actively seek new drugs and treatment strategies to address carbapenem-resistant Acinetobacter baumannii. This review summarizes the current status of infections caused by carbapenem-resistant Acinetobacter baumannii and its resistance mechanisms, providing scientific basis for future antibiotic research, clinical guidance, and prevention strategies.