Objective To observe the incidence and risk factors of pulmonary infection after surgery in traumatic brain injury (TBI) patients. Methods Two hundred and ninety‑four TBI patients after emergency neurosurgical treatment at Beijing Tiantan Hospital, Capital Medical University, between January 1st, 2016, and December 31st, 2018 were retrospectively collected. The patients were divided into an infection group (37 cases) and a non‑infection group (257 cases) according to whether pulmonary infection occurred after surgery. The incidence of pulmonary infection was recorded. The preoperative, intraoperative, and postoperative data of the two groups were compared. The variables with statistically significant differences between the groups were included in the univariate logistic regression analysis. The variables with P<0.1 in the univariate logistic regression analysis were included in the multivariate logistic regression analysis to analyze the independent risk factors of postoperative pulmonary infection in patients with TBI and factors of postoperative pulmonary infection in patients with severe TBI. The cost during hospitalization, hospitalization time, postoperative hospitalization time, admission rate to intensive care unit (ICU), ICU stay time, Glasgow Coma Score (GCS) at discharge, and mortality were compared between the two groups. Results The incidence of pulmonary infection was 12.6%. The proportion of drinking history and the proportion of cerebral hernia was high, and the time from admission to operation was short (all P<0.05) in the infection group compared to the non‑infection group. Compared with the non‑infection group, the intraoperative anesthesia time and operation time of patients in the infection group were long, the fluctuation of intraoperative systolic blood pressure (ΔSBP) was large, the proportion of glucocorticoids and vasoactive drugs, the amount of bleeding, the proportion of blood transfusion and the amount of blood transfusion was large, the amount of sufentanil and the proportion of consciousness recovery were low, and the proportion of retaining endotracheal tube (ETT) was high (all P<0.05). Compared with the non‑infection group, the postoperative albumin of patients in the infection group was low, and the proportion of antibiotics and the retention time of ETT was long (all P<0.05). Univariate logistic regression analysis showed that drinking history [odds ratio (OR) 2.713 (95% confidence interval (CI) 1.298, 5.670), P=0.008], low GCS at admission [OR 0.769 (95%CI 0.690,0.857), P<0.001], long anesthesia time [OR 1.445 (95%CI 1.155, 1.807), P=0.001], brain herniation [OR 2.434 (95%CI 1.209, 4.910), P=0.013], intraoperative blood transfusion [OR 1.058 (95%CI 1.025, 1.093), P<0.001], use of glucocorticoids [OR 2.517, (95%CI 1.171, 5.410), P=0.018], consciousness recovery [OR 0.270 (95%CI 0.080, 0.910), P=0.035], retaining ETT [OR 12.483 (95%CI 2.939, 53.025), P=0.001] were risk factors for postoperative pulmonary infection in TBI patients. Multivariate logistic regression analysis showed that drinking history [OR 2.689 (95%CI 1.184,6.107), P=0.018], low GCS at admission [OR 0.822 (95%CI 0.728, 0.929), P=0.002], and intraoperative blood transfusion [OR 1.042 (95%CI 1.006, 1.079), P=0.023] were independent risk factors for postoperative pulmonary infection in TBI patients. Drinking history [OR 5.038 (95%CI 1.831, 13.862), P=0.001] was a independent risk factor for pulmonary infection in patients with severe TBI. Compared with the non‑infection group, the infection group had high hospitalization costs, long hospitalization time, long ICU stay time, low GCS at discharge, and high mortality (all P<0.05). Conclusions The incidence of postoperative pulmonary infection in TBI patients was 12.6%. Drinking history, low GCS at admission, and intraoperative blood transfusion increased the risk of postoperative pulmonary infection in TBI patients.