Objective To identify the characteristics of and risk factors for intraoperatively acquired pressure injury (IAPI), and to provide references for prevention and management of IAPI. Methods Data were collected from 8 622 patients undergoing surgery in 7 first-class tertiary hospitals in China, including demographic data, surgical types, and characteristics of IAPI, then risk factors were analyzed. Results The prevalence of IAPI was 2.28%, with stage 1 pressure injury accounting for 91.24%. IAPI occurred most often in the sacrococcygeal region (46.08%), sitting position (13.64%), thoracic surgery (4.33%), and in patients 75-years-old and over (3.53%). The results of logistic regression analysis showed that ASA grade, skin state of the compressed site, preoperative limb movement, planned operation time, high-risk disease (diabetes), temperature loss factors, actual operation time were the predictors of IAPI (P<0.05, P<0.01). Conclusion IAPI was induced by several risk factors. The operating room nurses should identify risk factors and take personalized prevention and management measures to reduce the incidence of IAPI.