Objective To evaluate the efficacy of intermittent urethral catheterization based on safety bladder capacity for the prevention of neurogenic bladder-related urinary tract infection. Methods Patients with neurogenic bladder after spinal cord injury or cauda equina nerve injury in a hospital from January 2017 to December 2018 were selected and randomly divided into intervention group and control group according to random number table method. Control group was given routine intermittent urethral catheterization, catheterization frequency was based on post-void residual urine volume. Intervention group was given intermittent urethral catheterization, and catheterization frequency was based on the safety bladder capacity. Urinary tract infection rate, bacterial colony count and constituent, adverse reactions, post-void residual urine volume, as well as safety bladder capacity and detrusor wall thickness were compared between two groups of patients. Results A total of 120 patients were included in study, 60 in intervention group and 60 in control group, one patient in intervention group withdrew catheterization because he could not complete treatment course. Urinary tract infection rate in intervention group was lower than that in control group (10.17% vs 28.33%, χ²=6.295, P=0.012);the number of bacterial colonies in urine culture in intervention group was significantly lower than that in control group ([4.71±0.13] lg CFU/mL vs[4.99±0.25] lg CFU/mL, t=2.538, P=0.019); Gram-negative bacteria were main pathogens isolated from urine culture of both groups. After 8 weeks, post-void residual urine volume and detrusor wall thickness in intervention group were both lower than those in control group (t=2.323 and 3.412, respectively, both P < 0.05); safety bladder capacity in intervention group was significantly higher than that in control group (t=2.496, P=0.014). There was no significant difference in adverse reactions between two groups of patients (P>0.05). Conclusion Intermittent urethral catheterization based on safety bladder capacity can reduce neurogenic bladder-related urinary tract infection rate after spinal cord injury.