Abstract: OBJECTIVE To investigate the risk factors for postoperative hospital-acquired pulmonary infection in the elderly patients with hip fracture. METHODS A total of 224 elderly patients with hip fracture who were treated in Beijing Century Temple Hospital Affiliated to Capital Medical University from Jan 2013 to Feb 2018 were enrolled in the study, the baseline data of the patients were retrospectively analyzed, the enrolled patients were divided into the infection group and the non-infection group according to the fact whether the hospital-acquired pulmonary infection was occurred, the result of sputum culture for pathogens was observed, and the univariate analysis and multivariate logistic regression analysis were performed for the high-risk factors for the postoperative hospital-acquired pulmonary infection in the elderly patients with hip fracture. RESULTS Of the 224 elderly patients with hip fracture, 20 had postoperative hospital-acquired pulmonary infection, with the incidence rate 8.93%.Totally 20 strains of pathogens were isolated from the sputum specimens that were obtained from the 20 patients with pulmonary infection, 13（65.00%） of which were gram-negative bacteria, 5（25.00%） were gram-positive bacteria and 2（10.00%） were fungi.The multivariate logistic regression analysis showed that the advanced age, long interval between fracture and admission for treatment, complication with respiratory system disease, complication with nervous system disease, long operation duration, general anesthesia, smoking history, history of chronic obstructive pulmonary disease and anemia were the risk factors for the postoperative pulmonary infection in the elderly patients with hip fracture（P＜0.05）. CONCLUSION There are a variety of risk factors for the postoperative hospital-acquired pulmonary infection in the elderly patients with hip fracture.It is an effective way to actively correct the anemia, treat the complications and boost the lung function before the surgery and take targeted interventions after the surgery so as to reduce the risk of the postoperative hospital-acquired pulmonary infection and improve the prognosis of the patients.