ObjectiveTo analyze the risk factors for healthcareassociated pneumonia (HAP) in patients with orthopedic injury, provide the basis for making prevention and control measures. MethodsHAP occurred in patients with orthopedic injury and admitted to the department of orthopedics of a hospital from June 2011 to May 2015 were investigated retrospectively, risk factors were analyzed by univariate and multivariate logistic regression methods. ResultsA total of 2 578 patients with orthopedic injury were investigated, 92 patients developed HAI, incidence of HAP was 3.57%. 107 strains of pathogens were detected, the major were Klebsiella pneumoniae（n=22, 20.56%）, Escherichia coli (n=14, 13.08%）, and Acinetobacter baumannii(n=13, 12.15%). Risk factors for HAP in patients with orthopedic injury were length of hospital stay≥15 days, smoking history≥3 years, bedridden≥7 days, associated with underlying diseases, complications, indwelling catheter≥7 days, surgical operation, mechanical ventilation, admitted to intensive care unit, open injury, blood sugar≥11 mmol/L, plasma albumin＜30 g/L, hemoglobin concentration＜90 g/L, and use of glucocorticoid≥4 days (all P＜0.05）. Multivariate logistic regression analysis showed that smoking, bedridden, surgery, mechanical ventilation, glucocorticoid use, and anaemia were independent risk factors for HAP in patients with orthopedic injury. ConclusionThe occurrence of HAP in patients with orthopedic injury is related with multiple factors, the major are surgical operation, mechanical ventilation, glucocorticoid use, long term smoking, bedridden, and anaemia.