Objective To analyze and discuss the clinical characteristics and prognostic risk factors of 80 patients with tetanus in our hospital, and to provide a basis for tetanus in clinical diagnosis and treatment, early identification of risk factors and reduction of mortality. Methods The clinical case data of 80 tetanus patients were collected from our hospital from January 2013 to December 2020. A database of 20 factors that may affect the prognosis of tetanus was established, its clinical characteristics were summarized, and its prognostic risk factors were analyzed. Results Among the 80 patients, the main clinical manifestations were closed teeth (97.5%), dysphagia (92.5%), spasms and convulsions of extremities (77.5%), and the common complications were respiratory failure (32.5%) and myocardial damage (30%). The following 8 factors: ICU patients, mechanical ventilation, fever, concurrent respiratory failure, limb spasm and convulsions, Apache II score, Ablett classification, length of hospitalization, the difference between the death group and the survival group was statistically significant (P < 0.05). The logistic regression analysis suggested that Hospital stay, mechanical ventilation and Ablett classification were risk factors for prognosis of tetanus (P < 0.05). Conclusions The awareness of tetanus for manual workers should be strengthened. Complete debridement early after trauma and timely artificial immunization are the key measures to prevent tetanus; If patients with tetanus have long hospitalization time, mechanical ventilation and high Ablett grade, clinical management should be strengthened. [ABSTRACT FROM AUTHOR]