To investigate the status of hospital-acquired infection in neurosurgical inpatients and analyze its risk factors. Methods: A retrospective analysis was carried out on the clinical medical records of 4 716 patients admitted to the department of Neurosurgery. Univariate analysis and multi-factor logistic regression were applied to analyze the risk factors of nosocomial infection in hospitalized neurosurgery patients. Results: Of the 4 716 neurosurgical inpatients, 216 patients (4.6%) experienced hospital-acquired infection, amounting to 253 cases (5.4%). Regarding infection sites, 139 cases (55.0%) presented infection in the respiratory system, 50 cases (19.8%) in the central nervous system, 34 cases (13.4%) in the circulatory system, 16 cases (6.3%) at the surgical site, and 14 cases (5.5%) in the urinary system. Logistic regression results showed that smoking history (OR=1.734, 95% CI 1.073~2.802), emergency admission (OR=0.520, 95% CI 0.341~0.794), prolonged hospitalization (OR=1.114, 95% CI 1.090~1.140), admission to ICU (OR=2.256, 95% CI 1.319~3.857), mechanical ventilation (OR=2.032, 95% CI 1.263~3.270), artificial airway (OR=2.127，95% CI 1.018~4.444), indwelling venous catheter (OR=2.391, 95%CI 1.490~3.836), and hypothermia treatment (OR=3.334, 95%CI 1.732~6.418) were independent risk factors of hospital-acquired infection in neurosurgical inpatients. Conclusion: The incidence of hospital-acquired infection in neurosurgery patients is relatively high, and respiratory infection is most common.