Abstract: OBJECTIVE To explore the influencing factors for nosocomial infections in emergency critically ill patients and observe the distribution of pathogens. METHODS A total of emergency critically ill patients who were treated in the hospital from Jan 2012 to Dec 2016 were enrolled in the study, the clinical data of the patients with infections were retrospectively analyzed, the univariate analysis and multivariate logistic regression analysis were performed for the related influencing factors for the nosocomial infections, the clinical specimens that were obtained from the patients with infection were cultured, and the isolated pathogens were identified. RESULTS Of the 2700 emergency critically ill patients, 287 had nosocomial infections, with the infection rate 10.63%.The lower respiratory tract was the major infection site.The result of the multivariate logistic regression analysis showed that the age, length of hospital stay, invasive operations and use of antibiotics were the independent influencing factors for the nosocomial infections in the emergency critically ill patients.Totally 400 strains of pathogens were isolated, of which 240 (60.00%) were gram-negative bacteria, 120 (30.00%) were gram-positive bacteria and 40 (10.00%) were fungi. CONCLUSION The gram-negative bacteria are dominant among the pathogens causing the nosocomial infections in the emergency critically ill patients.The age, length of hospital stay, invasive operations and excessive use of antibiotics are the independent influencing factors for the nosocomial infections in the emergency critically ill patients.It is necessary to boost the idea of prevention of nosocomial infections and reasonable use of antibiotics in emergency department, reduce the invasive operations and reasonably use antibiotics so as to reduce the incidence of nosocomial infections in the emergency department.