Objective To investigate the risk factors for surgical site infection （SSI） during the perioperative period in patients with gynecological malignancies，providing evidence for preventing clinical infection and optimizing patient management. Methods Clinical data of 531 patients who underwent total hysterectomy with a confirmed diagnosis of gynecological malignancies at the First Affiliated Hospital of Soochow University from June 1，2016 to May 31，2024 were retrospectively collected. Patients were divided into an SSI group and a non-SSI group based on infection occurrence. Variables were collected and analyzed using univariate and multivariate logistic regression analyses，including age，body mass index，ASA score，medical history，laboratory blood test results，primary diseases and surgical details. Results Among 531 patients，46 developed SSI，yielding an incidence rate of 8.66%. Univariate analysis revealed significant associations between SSI and age，history of diabetes mellitus，anemia，ASA score，surgical approach，intraoperative blood loss，and perioperative prophylactic antibiotic use （P<0.05）. Multivariate analysis further identified age≥60 years，diabetes，anemia，ASA score ≥3，open abdominal surgery，and intraoperative blood loss ≥500 mL as independent risk factors for SSI （P<0.05）. Conclusions Advanced age，diabetes，anemia，high ASA score，open abdominal surgery，and significant intraoperative bleeding are key risk factors for SSI in gynecological malignancy patients. Clinical strategies should focus on optimizing perioperative management，including glycemic control，anemia correction，optimization of the surgical approach，and hemorrhage reduction，to decrease infection risks and improve patient outcomes.