Abstract: OBJECTIVE To analyze the influence of consciousness of stroke patients on nosocomial infections and prognosis. METHODS A total of 85 cases of stroke patients treated from Oct. 2015 to Jan. 2016 were selected, and were divided into coma group (33 cases) and awake group (52 cases) according to the consciousness state of stroke patients. According to the stroke type, the patients were given the corresponding treatment, and the patients with nosocomial infection should be treated with high sensitive antimicrobials in time. RESULTS In coma group, 22 cases occurred nosocomial infection, accounting for 66.67%, and in awake group, 10 cases occurred nosocomial infection, with the infection rate of 19.23%, and the difference was statistically significant (P<0.01). The distribution of pathogenic bacteria in coma group was significantly higher than that in awake group, and the difference was statistically significant (P<0.05). Before treatment, the CSS score gap between the two groups of infected patients was smaller, and after treatment, the CSS scores of both groups were reduced, and the difference was statistically significant (P<0.05). The CSS score of awake group reduced more than that of coma group, and the difference was significant (P<0.05). The effective rate of awake group was 90.00%, which was significantly higher than that of coma infection group (45.45%), and the difference was statistically significant (P<0.05). After treatment, the length of hospital stay was (31.2±5.6) days and the cost of hospitalization was (23.0±8.0) thousand yuan in coma group, which were significantly higher than those in awake group, and the difference was significant (P<0.05). CONCLUSION Stroke patients with coma are more susceptible to nosocomial infection, and the prognosis is poor after effective treatment, which is a major medical problem to be solved urgently.