Abstract: OBJECTIVE To reveal the epidemiological characteristics and changing trends of hospital-associated infections (HAIs) in Shandong Province so as to provide data support for prevention and control of the HAIs. METHODS The data regarding the prevalence rates of HAIs were systematically collected from Shandong Province from 2014 to 2024. The trend analysis of time variation was performed with the use of Cochran-Armitage trend test. The prevalence rates and isolation rates of pathogens in different department were demonstrated by clustering analysis and heat map. RESULTS The prevalence rates of HAIs ranged between 1% and 3% in Shandong Province, showing downward trends (P＜0.05); the prevalence rate of HAIs of the hospitals with the number of beds no less than 900 was highest (around 2%). The prevalence rates of community-acquired infections maintained 20% to 25%. The etiological submission rate for therapeutic antibiotics has been higher than 50% since 2022, showing an upward trend (P＜0.05). The prevalence rates of HAIs have always been high in general ICU, hematology department, neurosurgery department and burns department; the average prevalence rates were 19.22%, 7.27%, 6.74% and 5.79%, respectively. The average isolation rates of Klebsiella pneumoniae, Pseudomonas aeruginosa, Escherichia coli and Acinetobacter baumannii were 18.22%, 15.76%, 12.99% and 11.01%, respectively. CONCLUSIONS The prevalence rates of HAIs generally decline in Shandong Province, however, the prevalence rates of community-acquired infections maintain the previous levels, the high prevalence rates exist persistently in specific departments, indicating that the prevention and control of HAIs confronts great challenge. It is necessary to strengthen the management and intervention to the community-acquired infections and focus on the prevention and control of infections in key departments.