Abstract: OBJECTIVE To investigate the direct economic burden of the hemorrhagic stroke patients due to nosocomial infection. METHODS The targeted surveillance of nosocomial infection was conducted for the hemorrhagic stroke patients who were treated in Qilu Hospital of Shandong University from Jan 1, 2016 to Dec 31, 2018. The data of the patients, including demographic data, clinical course of disease, nosocomial infection-related data and hospitalization cost, were collected. The patients were divided into the infection group and the non-infection group according to the status of nosocomial infection, a 1∶1 case control matching was carried out for the two groups, and the hospitalization cost and length of hospital day were compared between the two groups of patients by using rank sum test. RESULTS Of totally 531 hemorrhagic stroke patients who were eligible for the inclusion criteria, 187 had nosocomial infection, with the incidence of nosocomial infection 35.22%. The median of total hospitalization cost was 125 793.42 yuan in the infection group, 80 020.38 yuan in the control group, the economic burden due to nosocomial infection was 45 773.04 yuan (Z=-5.695, P<0.001). The median of length of hospital stay was 19.00 days in the infection group, 12.00 days in the control group, the extended length of hospital stay due to nosocomial infection was 7.00 days, and there was significant difference in the length of hospital stay between the infection group and the non-infection group(P<0.001). CONCLUSION The nosocomial infection may lead to the increase of medical cost, extension of the length of hospital stay and increase of economic burden of the hemorrhagic stroke patients.