Abstract: OBJECTIVE To investigate the economic burden of the stroke surgery patients due to nosocomial infection so as to provide guidance for development of relevant policies. METHODS The related clinical data were retrospectively collected from the stroke patients who received surgery in Qilu Hospital of Shandong University from Jan 2016 to Dec 2018, the enrolled patients were divided into the infection group and the non-infection group according to the status of nosocomial infection. The age±10 years old, gender, surgery mode, surgery grade and number of times of surgery were used as variables and performed for 1∶1 matching,the excess medical cost of the stroke patients due to the nosocomial infection was estimated, and the economic loss of the hospital due to nosocomial infection was observed by means of marginal analysis. RESULTS Of totally 816 stroke patients, 216 had nosocomial infection, with the infection rate 26.10%. The proportion of total excess medical cost of the patients with nosocomial infection was about 26.58%. The economic loss of the hospital due to the nosocomial infection in the stroke patients was about 138,500 RMB (M%=5%), 276,600 RMB (M%=10%), and 415,100 RMB (M%=15%) in 2016, 161,200 RMB (M%=5%), 322,200 RMB (M%=10%), and 483,400 RMB (M%=15%) in 2017, 125,800 RMB (M%=5%), 25.14 RMB (M%=10%), 377,200 RMB(M%=15%) in 2018. The coefficient of the profit ratio of loss due to nosocomial infection and the infection rate was about 0.34. CONCLUSION The nosocomial infection in the stroke patients can result in huge amount of excess medical cost, reduce the economic profit of the hospital and increase the economic burden of the hospital, therefore, it is necessary for the clinical health care workers to take targeted prevention measures so as to reduce the incidence of nosocomial infection.