OBJECTIVES: To analyze AMR in Thailand.  METHODS: A systematic review over the period 1980 to present under the PRISMA guidelines using 4 databases: Pubmed; Sciencedirect; Health system research institute (HSRI) of Thailand; and Thai journal citation index centre (TCI). Key words used were [health care-associated OR nosocomial OR hospital acquired AND Economic* AND Thai*] AND [antimicrobial resistan* AND Thai*]. We also used key words in Thai language for Thai databases. Inclusion criteria: epidemiologic studies and pharmacoeconomic studies of bacterial resistance of nosocomial infection in Thailand. Exclusion criteria: pharmacokinetics, pharmacodynamics, pharmacologics, molecular and genomics studies. Studies in agricultures and livestock were also excluded. RESULTS: Nineteen studies met eligible criteria in this systematic review. There were 4 groups of study on AMR burden and situation. They were: 1) AMR situations: a systems analysis; 2) AMR burden: epidemiological burden such as surveillance studies from National Antimicrobial Resistance Surveillance Thailand (NARST) and national surveillance of nosocomial infections in Thailand from 1988-2006 and economics burden; 3) factors associated with AMR in Thailand; and 4) studies of AMR preventions and control programs in Thailand.  CONCLUSIONS: AMR is one of the major health problems in Thailand. The existing data lack clarity and are often unreliable to quantify an accurate amount of AMR burden. More valid and reliable data on the use of antimicrobials and of AMR as well as morbidity and mortality data related to AMR are needed in order to compute burden of AMR in Thailand at a national level and inform policy decision making.