ObjectiveTo analyze clinical characteristics of patients suffered from nervous system involved severe fever with thrombocytopenia syndrome (SFTS). MethodsClinical data of SFTS patients who were admitted to Qingdao Sixth People’s Hospital between January 2016 and December 2017 were retrospectively analyzed. According to whether there was nervous system involvement, they were divided into two groups, clinical data of two groups of patients were compared and analyzed; SFTS patients with nervous system involvement were subdivided into death group and survival group according to the final outcome, clinical data of two groups were compared and analyzed.ResultsThe median date of occurrence of neurological symptoms in SFTS patients was at day 6 of disease process. There were statistical differences in age， skin ecchymosis/severe bleeding tendency， Creactive protein, procalcitonin, Ca2+ on admission, CD4+ cell count, myocardial enzymes (LDH, CK, CKMB, HBDH), pulmonary inflammation, liver function (ALT, Alb, AST), and activated partial thromboplastin time (APTT) between nervous system involvement group and nonnervous system involvement group（all P＜0.05）. Among patients with nervous system involvement, there were statistical differences in skin ecchymosis, the lowest value of PLT, positive rate of SFTSVIgM antibody, CD3+ cell count, CD4+ cell count, LDH, Alb, and APTT between death group and survival group (all P<0.05).ConclusionMost SFTS patients with nervous system involvement are elderly patients with seriously damaged coagulation function, liver function, myocardial enzymes and immune system, proportion of pulmonary infection is high. Among SFTS patients with nervous system involvement, impairment of coagulation function, immune function, liver function, and myocardial enzymes in deceased patients are more serious than those in survivors.