ObjectiveTo explore the risk factors,clinical characteristics,prevention and treatment of fungal infections in severe patients after craniotomy.MethodsClinical data  of 27 severe patients with fungal infections after craniotomy in neurosurgery department in a hospital between January 2009 and June 2011 were analyzed retrospectively.ResultsOf  27 patients, 12 cases had lung fungal infections, 8  had urinary tract infections, 4 had gastrointestinal tract infections, 2 had surgical site infections,  and 1 had bloodstream infections; 22 cases improved or cured, 1 died, 4 patients gave up treatment and were discharged. The major risk factors for fungal infections in postoperative severe patients were coma, application  of broadspectrum antimicrobial agents and glucocorticoids, and a variety of invasive treatment operation. ConclusionThe key to the prevention of nosocomial fungal infection after craniotomy is the rational use of broadspectrum antimicrobial agents and glucocorticoids. The clinical manifestations of fungal infections are not typical. For postoperative severe patients who require longterm use of antimicrobial agents， antifungal agents should be used preventively; Patient who has fungal infection should  choose appropriate antifungal agents， antifungal agents should be used early,enough and full course.