[Objective] To explore the risk factors of poor incision healing after posterior pedicle screw fixation of thoracolumbar frac-tures. [Method] A total of 146 patients were included in this study, who underwent posterior pedicle screw fixation of thoracolumbar frac-tures in our hospital From June 2017 to September 2022. The patients were divided into two groups based on the condition of incision heal-ing: the poor incision healing group (PIH) and the good incision healing group (GIH). Univariate comparison and multivariate logistic regres-sion analysis were used to explore the risk factors for PIH. [Results] Among146 patients who underwent surgical treatment, 21 had PIH, ac-counting for 14.4%. As results of univariate comparisons, the PIH groups proved significantly greater than the GIH group in terms of age[(47.8±8.1) years vs (41.3±11.2) years, P=0.003], BMI [(26.0±5.3) kg/m2 vs (21.1±3.4) kg/m2, P＜0.001], history of diabetes [yes/no, (11/10)vs (10/115) , P＜0.001], operation time [(91.9±17.9) min vs (77.7±16.5) min, P＜0.001], and the ratio of posterior internal fixation and simpleminimally invasive internal fixation [fixation / open decompression fixation / minimally invasive fixation, (4/9/8) vs (76/18/31), P＜0.001].The multivariate logistic regression analysis showed that diabetes (OR=4.017, P=0.030), BMI (OR=1.178, P=0.009), and operation time(OR=1.036, P=0.040) were independent risk factors for poor wound healing after posterior pedicle screw fixation of thoracolumbar fractures.[Conclusion] The longer operation time, greater BMI and diabetes are the main factors related to poor wound healing after posterior pedi-cle screw fixation of thoracolumbar fractures.