Abstract: Objective To investigate the risk factors and nursing of acute respiratory failure after trauma. Methods Two hundred and fourteen patients admitted to our hospital from May,2014 to May,2016 were selected.And according to the presence or absence of respiratory failure,the patients were divided into observation group(with acute respiratory failure,61 cases) and control group(without acute respiratory failure,153 cases).The risk factors questionnaire was made,and the age,smoking history,diabetes mellitus and hypertension,respiratory disease history,shock duration time,trauma index and APACHE score of two groups were collected.The data were analyzed by univariate and logistic regression analysis. Results In all 214 trauma patients,61 had ARF,the incidence rate was 28.5%(61/214).Univariate analysis showed that age,diabetes mellitus and hypertension,respiratory disease history,shock duration time,trauma index and APACHE score were the single factor risk factors for ARF after trauma.Logistic regression analysis showed that age,diabetes mellitus and hypertension,respiratory disease history,shock duration time,trauma index and APACHE score were independent factor risk factors for ARF after trauma. Conclusion Trauma patients easily had ARF,and age,diabetes mellitus and hypertension,respiratory disease history,shock duration time,trauma index and APACHE score were the risk factors of ARF after trauma.Risk factors in clinical should be judged,and good treatment and nursing of disease should be done.