Objective To identify the risk factors of pulmonary infection in the elderly patients with terminal-stage cancer in hospice. Methods Clinical data of 143 elderly patients with terminal-stage cancer hospitalized in our department from October 2012 to November 2013 were collected and retrospectively analyzed. A multivariate logistic regression analysis was carried out in the patients with pulmonary infection (n＝87) and those without (n＝56) for the risk factors of pulmonary infection. Results Variables significantly associated with increased risk of pulmonary infection included lung cancer [odds ratio (OR)＝4.137; 95% confidence interval (CI) 1.967 to 14.479), disturbance of consciousness (OR＝3.728; 95% CI 1.313 to 8.315), hypoalbuminemia (OR＝2.960; 95% CI 1.300 to 6.739), hospital stay (OR＝2.611; 95% CI 1.056 to 6.451), performance status (OR＝2.187; 95% CI 1.345 to 4.071), diabetes mellitus (OR＝1.937; 95% CI 1.159 to 3.238), and chronic obstructive pulmonary disease (COPD; OR＝1.823; 95% CI 1.056 to 3.891) in this elderly cohort with terminal stage cancer (all P＜0.05). Conclusion Pulmonary infection is common in the elderly patients with terminal stage cancer. Lung cancer, disturbance of consciousness, hypoalbuminemia, prolonged hospitalization, bedridden, and chronic comorbidity (diabetes mellitus and COPD) are risk factors for occurrence of pulmonary infection.