Objective To understand the epidemiological characteristics of infection in recipients after heart transplantation, and provide references for the prevention and control of postoperative infections. Methods Clinical data of 259 heart transplant recipients in a hospital from April 2018 to December 2023 were collected for epidemiological analysis. Results Among 259 heart transplant patients, 55 developed 68 episodes of infection during the first hospitalization after surgery, the incidence of infection was 21.24%, and the case incidence of infection was 26.25%. The main infection sites were lower respiratory tract (n=30, 44.12%), blood system (n=21, 30.88%), and urinary system (n=8, 11.76%). Sixty-eight episodes of infections occurred primarily within 10 days after surgery (n=37, 54.41%), fo-llowed by within 11-20 days (n=14, 20.59%).A total of 74 pathogens were detected from the infected site, mainly Gram-negative bacteria (n=37, 50.00%), followed by fungi (n=19, 25.68%), Gram-positive bacteria (n=12, 16.22%), viruses (n=6, 8.11%). The multidrug-resistant rates of Klebsiella pneumoniae, Acinetobacter baumannii, Pseudomonas aeruginosa, and Enterococcus spp. were relatively high (57.1%-100%). During the period from discharge to one year after surgery, 31 patients developed 39 episodes of infection, mainly lower respiratory tract infection (n=29, 74.36%). Conclusion Heart transplant recipients have a high incidence of postoperative infection, with lower respiratory tract being the main infection site and with a high resistance rate of pathogen. The critical period for infection prevention and control is within 10 days after surgery.