Abstract: OBJECTIVE To investigate the incidence of nosocomial infections in stroke patients undergoing surgical procedures and analyze the economic burden so as to provide guidance for development of related policies. METHODS The prevalence of nosocomial infections in the stroke patients who underwent surgical procedures in wards of neurosurgery departments of a three-A tertiary hospital from Jan 1, 2016 to Dec 31, 2017 was investigated.By means of a 1∶1 ratio of case-control study, the chi-square test was performed to compare the length of hospital stay and hospitalization costs between the infection group and the non-infection group, and the economic burden due to the nosocomial was calculated. RESULTS Of the 466 enrolled stroke patients, 133 had nosocomial infection, with the infections rate 28.54%.The median hospitalization cost was 126280.08 yuan in the infection group, 72333.87 yuan in the non-infection group, and there was significant difference between the two groups (Z=-6.698,P＜0.001).The direct economic burden due to nosocomial infections was 53946.21 yuan, the median length of hospital stay was 19 days in the infection group, 13 days in the non-infection group, and there was significant difference between the two groups (Z=-6.726,P＜0.001).The length of hospital stay of the patients extended by 6 days due to the nosocomial infections; the indirect economic burden was 2055.6 yuan due to the nosocomial infections, and the total economic burden was 56001.81 yuan due to the nosocomial infections. CONCLUSION The nosocomial infections in the stroke patients undergoing surgical procedures may lead to the increase of hospitalization cost and extension of length of hospital stay and bring tremendous economic burden to the patients.