This study was performed to investigate the risk factors related to surgical site infection (SSI) secondary to spinal internal fixation via the posterior approach.Patients who had undergone spinal internal fixation via the posterior approach were selected for inclusion in this cross-sectional study. Factors related to SSI were analysed using univariate and multivariate analyses.Among 4,350 patients, 66 had SSI (infection prevalence of 1.5%). Multivariate logistic regression analysis demonstrated that age of >60 years, surgical duration of >3 hours, haemoglobin concentration of <80 g/L, serum albumin concentration of <30 g/L, diabetes history, and blood loss of >1,000 mL were significantly correlated with SSI secondary to spinal internal fixation via the posterior approach.This study provides information on SSI secondary to spinal internal fixation via the posterior approach. We found that age of >60 years, surgical duration of >3 hours, haemoglobin concentration of <80 g/L, serum albumin concentration of <30 g/L, diabetes history, and blood loss of >1,000 mL are directly correlated with SSI secondary to spinal internal fixation via the posterior approach.