Objective To analyze the risk factors for healthcare-asssociated infection (HAI) in patients with acute organophosphorus pesticide (OP) poisoning in Zhoukou City, provide scientific basis for taking targeted intervention measures. Methods Patients with acute OP poisoning treated in 9 hospitals in Zhoukou City from 2018 to 2020 were selected for retrospective study, HAI and its influencing factors were analyzed. Results A total of 959 patients with acute OP poisoning were collected, incidence of HAI was was 5.6%, the main HAI site was lower respiratory tract (n=43, 76.8%). The age and days of mechanical ventilation in cute OP poisoning patients with HAI were significantly higher than those in patients without HAI (both P < 0.05). Incidence of HAI was higher in patients with chronic respiratory diseases, low cholinesterase activity, severe poisoning, coma, invasive procedure, as well as use of glucocorticoid, immunosuppressive agents and antimicrobial agents, differences were all statistically signi-ficant (all P < 0.05). Multivariate logistic regression analysis showed that long-term mechanical ventilation, history of chronic respiratory diseases, use history of immunosuppressive agents and and antimicrobial agents were independent risk factors for HAI in patients with acute OP poisoning (all P < 0.05). Conclusion Incidence of HAI in patients with acute OP poisoning is high, mainly lower respiratory tract infection, comprehensive preventive mea-sures should be taken according to its influencing factors, so as to reduce the incidence of HAI.