Abstract: OBJECTIVE To explore the risk factors for healthcare-associated infections (HAIs) in elderly patients in ICUs so as to provide guidance for control of the HAIs. METHODS A total of 1 269 elderly patients with no less than 65 years of age who were treated in the comprehensive ICUs from Jan 2012 to Dec 2014 were enrolled in the study and divided into the infection group with 195 cases and the control group with 1 074 cases according to the status of HAIs during the ICU stay.The related data were observed and compared between the two groups of patients, the independent risk factors for the HAIs were analyzed, and the statistical analysis was performed with the use of SPSS21.0 software. RESULTS The average length of hospital stay of the infection group was 38 days, longer than 19 days of the control group(P＜0.01).The mortality rate of the infection group was 43.08%, higher than 26.54% of the control group(P＜0.01).The average hospitalization cost of the infection group was 162 720 yuan, more than 67 565 yuan of the control group(P＜0.01).The independent risk factors for the HAIs included the pancreatitis (OR=5.20,95%CI 2.83~9.56), ICU stay for many times (OR=4.22,95%CI 2.83~6.32), hospital-acquired multidrug-resistant organisms (MDROs) (OR=3.47,95%CI 2.37~5.07), and APACHEⅡ score(OR=1.04,95%CI 1.01~1.06). CONCLUSION The HAIs in the elderly patients may extend the length of hospital stay and increase the mortality rate as well as the economic burden.The independent risk factors for the HAIs in the elderly patients include the pancreatitis, ICU stay for many times, hospital-acquired MDROs, and APACHEⅡ score.