Objective To explore the clinical characteristics, laboratory examination and prognostic risk factors of invasive pulmonary aspergillosis (IPA). Methods Clinical data of IPA patients in a hospital from September 2020 to June 2023 were retrospectively analyzed. Clinical characteristics and prognostic risk factors of patients were analyzed. Results A total of 111 patients with IPA were analyzed, aged (68.8±12.5) years old, mainly male (63.1%), and were mainly distributed in the department of respiratory diseases, intensive care unit (ICU), departments of hematology and infectious diseases, accounting for 75.6% in total. The common Aspergillus in IPA were Aspergillus fumigatus, Aspergillus flavus and Aspergillus niger, accounting for 67.6%, 19.8% and 4.5% respectively. The positive rates of (1, 3)-β-D-glucan antigen test (G test)and galactomannan antigen test (GM test) for bronchoalveolar lavage fluid (BALF) were 73.7% and 68.0%, respectively. Of 111 IPA patients, 32 (28.8%) had poor prognosis and 25 (22.5%) were complicated with viral infection. Multivariate logistic regression analysis showed that combined with viral infection (OR [95%CI]: 4.535 [1.385-14.846], P=0.012), glucocorticoid use history for 3 consecutive weeks (OR [95%CI]: 9.128 [2.293-36.341], P=0.002), mechanical ventilation (OR [95%CI]: 4.690 [1.100-19.990], P=0.037) and indwelling urinary catheter (OR [95%CI]: 7.144 [1.345-37.950], P=0.021) were independent risk factors for poor prognosis in IPA patients. Conclusion Multiple factors are related to the poor prognosis of IPA, and multiple methods should be combined to perform early identification and rational treatment for improving patient prognosis, corresponding preventive measures should be taken to avoid the occurrence of healthcare-associated infection.