Objective To analyze the incidence and risk factors of pulmonary infection after traumatic brain injury (TBI) surgery, in order to identify the risk factors and high-risk population of pulmonary infection after TBI surgery, and to provide more basis and support for the development of prevention and treatment plans of pulmonary infection after TBI surgery. Methods A total of 200 TBI patients who underwent surgical treatment from June 2019 to June 2022 were selected as study subjects, and their clinical data were retrospectively analyzed. Results The incidence of pulmonary infection after TBI was 30.00% (60/200). Univariate results showed that age, surgical risk, preoperative GCS score, surgical times, surgical duration, endotracheal intubation or incision, mechanical ventilation time, use of immunosuppressive agents, aspiration, drainage tube, ICU stay time, and postoperative hypoproteinemia were significantly different between the pulmonary infection group and the non-pulmonary infection group (P<0.05). Multivariate results showed that advanced age, ≥2 operations, long operation duration, endotracheal intubation or incision, long mechanical ventilation time, aspiration, indwelling drainage tube, long ICU stay time, and postoperative hypoproteinemia were all risk factors for pulmonary infection after TBI (P<0.05). Conclusion The occurrence of pulmonary infection after TBI is affected by many factors. Therefore, comprehensive evaluation and analysis should be carried out after admission, and measures should be taken as early as possible for high-risk groups to reduce the incidence of pulmonary infection after TBI and improve the prognosis of patients.