Abstract: OBJECTIVE To analyze the pathogenic characteristics and related factors of postoperative nosocomial infections in patients with primary hepatic carcinoma. METHODS A total of 150 patients with primary hepatic carcinoma from Jan. 2015 to Dec. 2016 in our hospital were selected, and the related factors of postoperative infections, distribution of pathogens and drug sensitivity test results were analyzed. RESULTS There were 33 cases of postoperative infections of primary hepatic carcinoma, and the infection rate was 22.00%. Totally 88 strains of pathogens were isolated, including 53 strains of gram-negative bacteria accounting for 60.23%, mainly Escherichia coli, 33 strains of gram-positive bacteria accounting for 37.50%, mainly Enterococcus, and 2 strains of fungi accounting for 2.27%. Gram-negative bacteria had high resistant rates to cefazolin, ceftriaxone and ampicillin, some up to 100%, and were sensitive to ceftizoxime, imipenem, piperacillin sulbactam and cefoperazone/sulbactam. Gram-positive bacteria were generally resistant to ampicillin and clindamycin, but were still relatively sensitive to vancomycin, teicoplanin and rifampin. Age, hepatic insufficiency, operation time, blood loss, transfusion factors, intraoperative injuries, left and right hepatic duct and postoperative T tube drainage were the independent risk factors of postoperative infections in patients with primary hepatic carcinoma (P<0.05). CONCLUSION The main pathogens causing postoperative infections in patients with primary hepatic carcinoma are gram-negative bacteria, we should choose ceftizoxime, imipenem, piperacillin sulbactam and cefoperazone/sulbactam and other sensitive drugs, and appropriate precautions should be taken according to the risk factors for infections.