Objective To understand the occurrence, pathogen distribution, and influencing factors for fungal infection in hospitalized patients with acquired immunodeficiency syndrome (AIDS) in an infectious diseases hospital. Methods AIDS patients who were hospitalized in a hospital for the first time from January 2018 to September 2019 were selected as the research objects, fungal infection was determined through culture. Logistic regression analysis was used to determine the influencing factors for fungal infection in hospitalized AIDS patients. Results There were 667 hospitalized AIDS patients from January 2018 to September 2019, 195 (29.24%) of whom had fungal infection. The main infection strains were Candida albicans (163 strains), Cryptococcus neoformans (36 strains) and Talaromyces marneffei (22 strains). The main sources of specimens were oral swabs (leukoplakia, 133 strains), sputum (41 strains) and blood (31 strains), oral swabs and sputum mainly isolated Candida albicans (119, 18 strains respectively); blood specimens mainly isolated Talaromyces marneffei (15 strains). Combined use of antimicrobial agents (OR=2.237, 95% CI: 1.190-4.204), combined with other infectious diseases (OR=1.614, 95% CI: 1.013-2.574) and high HIV-1 RNA load (OR=1.817, 95% CI: 1.039-3.176) were independent risk factors for fungal infection in hospitalized AIDS patients (all P < 0.05); systemic antiviral therapy (OR=0.736, 95% CI: 0.576-0.940), high CD4⁺ T cell level (OR=0.583, 95% CI: 0.351-0.968) and high lymphocyte count (OR=0.798, 95% CI: 0.644-0.988) were independent protective factors for fungal infection in hospitalized AIDS xpatients (all P < 0.05). Conclusion Incidence of fungal infection in hospitalized AIDS patients is high, which can be reduced through conducting systematic examination and standardizing antiviral treatment early, improving blood protein level and nutritional status, reducing invasive diagnosis and treatment procedure, rationally selecting antimicrobial agents and standardizing types and dosage of antimicrobial agents.