Abstract: Objective To explore the risk factors of perioperative period in elderly patients with thoracic surgery and to develop some reasonable care strategies to reduce the risk of postoperative infection. Methods Totally 432 cases of chest surgery in elderly patients with clinical data were analyzed. The 432 patients, which were treated in Huzhou central hospital of Zhejiang from May, 2015 to May, 2016, were divided into two groups, nosocomial infection (36 cases) and uninfected group (396 cases). Statistical analysis runs to analyze the correlation between the patients' infection and clinical data, thus to make corresponding nursing treatment. Results Thirty-six patients (8.3%) out of 432 the elderly patients after thoracic surgery were infected and the rest did not show infection (91.7%). Among them, the lower respiratory tract infection occurred in 24 cases, accounting for about 58.5% of the cases of infection. And 5 cases infections occurred in the upper respiratory tract (12.2%); 3 cases infections occurred in the epidermal incision (7.3%); 4 cases infections occurred in the deep incision (9.9%); 3 cases infections occurred in the pleural cavity (7.3%); 2 cases infections occurred in the urinary tract (4.8%). Through single factor analysis, we found that infection of patients were related with age, smoking history, duration of hospital stay and risk factors score (χ²=5.527, 8.569, 4.159, 7.421, respectively), and the difference was statistically significant (P<0.05); and the statistical analysis showed infections had no correlations with gender, surgery time, blood loss (P>0.05). Conclusion Age, history of smoking, duration of hospital stay and risk factors score were high risk factors for elderly patients of thoracic surgery in the perioperative period. Comprehensive improvement of nursing measures can effectively reduce the incidence of postoperative infection and complications. And it had important guiding significance to the success of surgery.