Abstract: Objective: To quantify the risk factors for Intensive Care Unit Acquired Weakness (ICU-AW) among patients with severe chest injury, so as to provide theoretical basis for early identification and prevention of ICU-AW. Methods: By convenient sampling method, 180 patients with severe chest injury in the department of thoracic surgery ICU of a tertiary grade A hospital were recruited. Relevant data of patients were collected by patient general data questionnaire and risk factor collection table. The risk factors of ICU-AW were obtained by Logistic regression analysis. Results: Seventy three patients were complicated with ICU-AW, and the incidence of ICU-AW was 40.56%. Binary Logistic regression analysis results showed that: older age, high APACHEⅡ score, multiple organ dysfunction syndrome, more mechanical ventilation time, activity restriction, the use of glucocorticoids, and the high level of blood lactic acid were risk factors for ICU-AW in patients with severe chest injury (P<0.05). Conclusion: The incidence of ICU-AW is high and the risk factors are complex in patients with severe chest injury. Clinical medical staff should pay more attention to elderly patients, conduct APACHEⅡ scoring of patients admitted to ICU in time, identify patients with multiple organ dysfunction syndrome, develop individualized mechanical ventilation plan according to the severity of the patient's chest trauma, closely monitor the systemic symptoms and muscle strength changes in patients with long-term heavy use of glucocorticoid, and monitor the level of blood lactic acid of patients, thereby preventing the occurrence of ICU-AW in patients with severe chest injury, and ultimately improving the quality of nursing management of patients with severe chest injury.