Abstract: Objective To investigate the predisposing factors and preventive measures of the patients with severe hepatitis and pulmonary infection, and to provide a reference basis for clinical treatment. Methods A total of 482 cases with severe hepatitis were selected from January 2014 to January 2016 in our hospital. Single factor and multiple factors Logistic regression model analyses were used to analyze associated risk factors of pulmonary infection in patients with fulminant hepatitis, and SPSS 18.0 software was used for statistical analysis. Results Of the 482 patients with hepatitis B cirrhosis, 98 cases were with pulmonary infection, and the infection rate was 20.33%; Clinical features such as fever, cough, sputum, lung sounds and chest X-ray, CT changes and elevated blood neutrophils were the most common,the mortality rate was 21.43%. 72 pulmonary infection patients were with a single pathogen infection, while 26 cases were with a mixed infection. 53 (47.32%) strains were of gram positive bacteria, 51 (45.54%) strains were of gram-negative bacteria, eight (7.14%) strains were of fungi. Multivariable Logistic regression analysis showed that age, length of hospital stay, severity, diabetes mellitus, upper gastrointestinal bleeding, invasive operation, use of antimicrobial agents and the concentration of serum albumin were independent risk factors for pulmonary infection. Conclusions There are many factors associated with pulmonary infection in patients with fulminant hepatitis. Therefore, in the process of treatment, it is necessary for targeted prevention and treatment, in order to improve the survival rate of patients with severe hepatitis.