Objective To evaluate the risk of healthcare-associated infection (HAI) of skin and soft tissue in patients receiving Chinese medicine leech therapy. Methods Clinical data of 100 hospitalized patients who received Chinese medicine leech therapy (therapy group) from January 1 to December 31, 2021 in the rheumatology department of a hospital and 666 patients who didn't receive leech therapy (non-therapy group) during the same period were collected retrospectively, incidence of skin and soft tissue infection between two groups of patients was compared, and the potential pathogens carried by leeches were found through pathogenic culture. Results One case of skin and soft tissue HAI occurred in both therapy and non-therapy groups respectively, incidence of HAI were 1.0% and 0.2% respectively, difference was not significant between two groups of patients (P=0.244). Specimens of 30 leech surface and nutrient fluid were collected, and 29 (96.7%) of them isolated Alcaligenes faecalis and Providencia rettgeri. Conclusion The risk of skin and soft tissue infection caused by Chinese medicine leech therapy is low, but leech body surface and nutrient fluid often contaminate opportunistic pathogens, it is still important to strengthen control and monitor on infection after therapy.