Objective To evaluate the effect of targeted monitoring and multi-modular improvement strategy on the prevention and control of catheter-associated urinary tract infection (CAUTI). Methods Patients with indwe-lling urinary catheter in a tertiary first-class hospital from January 2018 to December 2022 were selected as the research subjects. Targeted monitoring results and distribution of pathogenic bacteria in 5 consecutive years were analyzed, and a multi-modular improvement strategy based on the targeted monitoring results was implemented. The occurrence of CAUTI before and after implementation, status and effectiveness of training in prevention and control measures were compared respectively. Results Before and after the implementation of the multi-modular improvement strategy, health care workers' compliance rate of hand hygiene, awareness rate of prevention and control measures, and implementation rate of prevention and control measures all increased significantly (all P < 0.001). Targeted monitoring results showed that daily test rates of urine culture and routine urine from patients with indwelling catheters have been on the rise in 5 consecutive years (P < 0.05). A total of 397 cases of CAUTI occurred in the past 5 years. Incidences of CAUTI in general intensive care unit(ICU) and surgical ICU showed decreasing trends in 5 consecutive years (all P < 0.05). Incidence of CAUTI in general wards showed no statistically significant difference in 5 years (P=0.088). A total of 431 strains of pathogenic bacteria were detected, mainly Gram-negative bacteria. Daily incidence of multidrug-resistant organism infection in patients with indwelling catheters was 0.12‰. After the implementation of the multi-modular improvement strategy, incidence of CAUTI in all departments reduced significantly (P < 0.05). Conclusion Targeted monitoring can help identify departments with high-risk of CAUTI, multi-modular improvement strategy can raise the quality of prevention and control of CAUTI in all occasions, reduce the incidence of CAUTI, and is worthy of clinical promotion and application.