Adolescent and young adults (AYAs) belong to a unique category of patients diagnosed with acute lymphoblastic leukemia (ALL) who have better outcomes when treated with pediatric-inspired regimens. Bloodstream infections (BSIs) is a leading cause of treatment-related mortality in ALL patients. However, the epidemiology and prognostic characteristics of BSIs in ALL patients with AYAs remain unclear. In this study, we analyzed the epidemiology and prognostic factors of AYAs and compared the similarities and differences between younger and older adult patients with BSIs. We analyzed the clinical data of three comprehensive hospitals in Hunan Province, China, from January 2010 to August 2021. In this study, the clinical characteristics and pathogen distributions of AYAs patients were similar to those of adult ALL patients. Extended-spectrum beta-lactamase(ESBL)-producing bacteria were more commonly found in AYAs than in children (32.8% vs. 16.4%, P=0.09). Regarding prognostic factors, the length of hospitalization (>14 days) and renal inadequacy (creatinine≥177μmoI/L) were risk factors for 30-day mortality in AYAs with BSIs. In our study, AYAs patients with BSIs showed clinical characteristics and pathogen distributions similar to those of adult patients, but were quite different from those of children.