Abstract: OBJECTIV To analyze the risk factors of postoperative nosocomial infections in patients with transoral atlantoaxial reduction plate (TARP) fixation, and its influences on prognosis, so as to point out clinical management countermeasures. METHODS Totally 121 cases of patients after TARP operation from July 1st 2013 to June 30th 2015 were selected for the study, and the postoperative infection rate and infection related factors were analyzed. RESULTS The incidence of nosocomial infection rate was 16.53%(20/121), and case-time infection rate was 18.18% (22/121). The main infection sites were lower respiratory system (9/99, 40.91% ), urinary tract (5/22,22.73%) and surgical sites (4/22, 18.18%). Univariate analysis showed statistically significant risk factors were involved hospital stay, operation time, intraoperative blood transfusion, intraoperative injection volume, using respiratory machine, concomitant underlying diseases, mouth diseases, postoperative fever with the temperature over 38℃, multiple ICU stay, and hospital acquired multi-drug resistant bacteria. Binary logistics regression analysis revealed that using respirator, hospital acquired multi-drug resistant bacteria, mouth diseases and intraoperative injection volume were independent risk factors of nosocomial infections for patients with TARP. CONCLUSION There are considerable risk factors of nosocomial infections for patients with TARP surgery. We should take active prevention and control measures focusing on all kinds of risk factors, especially pay attention to management of respirator, multi-drug resistant bacteria, oral nursing and intraoperative injection control, so as to reduce the incidence of nosocomial infection and enhance the curative rate.