Objective：To explore the risk factors for premature infants with failed hearing screening. Methods：Clinical data of 665 premature infants were analyzed by Chi-square test and multivariate logistic regression analysis. Risk factors for premature infants who failed hearing screening were identified. Results：Totally 20.8% premature infants failed hearing screening. Single factor analysis indicated that gestational age，birth weight，hyperbilirubinemia，bilirubin encephalopathy，neonatal hypoxic-ischemic encephalopathy （HIE），neonatal syphilis，pyogenic meningitis，neonatal asphyxia might be the risk factors for failed hearing screening in premature infants（P＜0.05）. Multivariate analysis indicated that gestational age，birth weight，hyperbilirubinemia，HIE，syphilis，asphyxia were risk factors for failed hearing screening（respective OR：2.927，2.627，2.956，1.813，5.971，and 1.906）. Conclusion：Gestational age ＜34 weeks，birth weight<1 500 g，hyperbilirubinemia，HIE，syphilis，asphyxia are risk factors of failed hearing screening in premature infants and effective measures should be taken.