〔Abstract〕 Objective To analyze the etiological characteristics and risk factors of autosomal dominant polycystic kidney disease (ADPKD) complicated with urinary tract infection (UTI). Methods A retrospective analysis was performed on 244 patients with ADPKD admitted to the Department of Nephrology between March 2018 and March 2024. The patients were stratified into a study group (n=138) and a control group (n=106) according to the presence or absence of concurrent UTI. All patients in the study group underwent etiological testing and drug susceptibility testing. Clinical data of both groups were collected to identify the risk factors for ADPKD complicated with UTI. Results A total of 105 pathogens were detected in 138 cases in the study group, including 79 Gram-negative bacteria, 20 Gram-positive bacteria and 6 fungi. Escherichia coli showed a relatively high resistance rate to ampicillin, piperacillin and ciprofloxacin. Enterococcus faecalis had a relatively high resistance rate to tetracycline. There were statistically significant differences between the study group and the control group in terms of gender, history of urinary tract infection, C-reactive protein (CRP), increased urine red blood cells, increased urine white blood cells, increased percentage of neutrophils, blood sodium, blood calcium, total cholesterol, serum iron and transferrin saturation (P<0.05). Multivariate binary Logistic regression analysis revealed that female gender (OR = 2.236, P = 0.004), history of urinary tract infection (OR = 2.383, P = 0.002), increased urine white blood cells (OR = 2.726, P = 0.001), increased percentage of neutrophils (OR = 1.040, P = 0.010), elevated C-reactive protein (OR = 1.011, P = 0.007) and elevated blood calcium (OR = 4.389, P = 0.024) were risk factors of urinary tract infection in ADPKD patients (P<0.05). Conclusion The main pathogens of UTI in patients with ADPKD are Gram-negative bacteria. Female, previous history of urinary tract infection, urinary leukocytosis, increased percentage of neutrophils, increased CRP and increased serum calcium are risk factors of UTI.