Abstract: OBJECTIVE To investigate the prevalence of Clostridium difficile in neurosurgery department patients at admission to hospital and analyze the risk factors for colonization of C.difficile. METHODS The stool samples were collected from the patients who were just admitted to the wards of neurosurgery department of the Hospital Affiliated to Xuzhou Medical University from Nov 2018 to Apr 2019 so as to carry out the culture of toxigenic C.difficile and A/B toxin test, and the risk factors for colonization of toxigenic C.difficile were analyzed in combination with the baseline data and medical records of the patients. RESULTS A total of 26 (16.15%) strains of C.difficile were isolated from the 161 stool samples, 4 of which were non-toxigenic C.difficile, and 22 were toxigenic C.difficile, and the colonization rate of toxigenic C.difficile was 13.66%. Logistic regression analysis showed that history of use of antibiotics within 3 months, history of hospital stay within 3 months and history of diabetes mellitus were the independent risk factors for the colonization of C.difficile, and the OR values were 3.55(95%CI:1.1~11.47), 3.80(95%CI:1.13~12.76) and 4.60(95%CI:1.06~19.95), respectively. CONCLUSION The colonization rate of the toxigenic C.difficile in the neurosurgery department patients ranges between the ratios of other hospitals at the admission to hospital. Previous use of antibiotics, history of hospital stay and history of diabetes mellitus may increase the risk of colonization of C.difficile. It is necessary to strengthen the monitoring and screening of relevant patients and conduct further study to verify whether targeted prevention measures need to be formulated.