Objective:To investigate the risk factors of acute gastrointestinal failure in patients with traumatic brain injury(TBI).Methods:A retrospective analysis of 297 patients admitted to the Rugao Hospital Affiliated to Nantong University for traumatic brain injury from March 2018 to March 2020 was performed. Multivariate Logistic regression analysis was used to test the risk factors of acute gastrointestinal failure in patients with traumatic brain injury.Results:Of the 297 patients with TBI, 92 (30.98%) had acute gastrointestinal failure, of which 56 (18.86%) were acute gastrointestinal injury(AGI) Ⅲ and 36 (12.12%) were AGI Ⅳ. Multivariate Logistic regression analysis showed that female, low Glasgow Coma Scale (GCS) scores, frontal lobe injury, abnormal serum sodium, lung infection and intracranial infection were independent risk factors for acute gastrointestinal failure in TBI patients ( P<0.05). The length of ICU stay in the acute gastrointestinal failure group was significantly higher than that of the non-acute gastrointestinal failure group: (18.5 ± 2.6) d vs. (6.3 ± 1.2) d, and the incidence of good prognosis was significantly lower than that of the non-acute gastrointestinal failure group: 60.87%(56/92) vs. 80.49(165/205), the differences were statistically significant ( P<0.05). Conclusions:That female, low GCS scores, frontal lobe injury, abnormal serum sodium, lung infection and intracranial infection are independent risk factors for acute gastrointestinal failure in TBI patients