Background: The elderly inpatients are in high risk of suffering health-care associated infection (HAI). The study aimed to analyze the risk factors of health-care associated infection (HAI) in elderly hospitalized patients to prevent it and improve the recovery rate of elderly patients. Methods: The study was a Retrospective Cohort Study based on a 3-year surveillance in elderly inpatients in a large tertiary hospital in China. A retrospective review of the elderly inpatients >= 60 years with or without HAI were conducted. Binary multivariable logistic regression was used to evaluate the potential association between HAI and risk factors. Results: We investigated a total of 60,332 subjects aged 60 years old or above. The incidence of HAI in elderly was 2.62%. With adjustment for some factors, advanced age, hospital days before HAI, intensive care unit (ICU) admission, use of ventilator, central line catheter or urinary catheter and cerebral hemorrhage, cerebral infarction, brain neoplasms, diabetes mellitus, coronary artery disease, malignant tumor and malignant hematonosis had significantly increased odds ratios (OR) of suffering from HAI compared with the control group but body weight and operation decreased OR. Conclusion: Our findings suggested that advanced age, accompanied by some neurological and chronic noncommunicable diseases, hospital days before HAI, ICU admission, and use of devices were risk factors of suffering HAI in the elderly but the body weight and operation were the potential protective factors in this sample.