Objective To investigate the effect of HBV infection on wound healing in elderly patients undergoing hip arthroplasty, and to preliminarily analyze the risk factors for poor wound healing in these patients. Methods A total of 180 patients undergoing hip arthroplasty in our Orthopedic Department from January 2014 to June 2018 were retrospectively analysed in this study. According to whether having preoperative HBV infection or not, they were divided into HBV infection group and non-HBV infection group. All patients underwent femoral head replacement or total hip arthroplasty with anterolateral approach. The general conditions, laboratory indicators, intraoperative and incision conditions were compared between the 2 groups, and the risk factors for poor incision healing in patients with HBV infection were analyzed. SPSS statistics 19.0 was used to analyze the data. Independent sample t test or Chi-square test was used for comparison between groups based on data types. Univariate and multivariate logistic regression analysis were used to analyze the influencing factors of incision in HBV patients. Receiver operating characteristic (ROC) curve was used to analyze the predictive value of albumin and intraoperative bleeding volume for poor incision healing in HBV patients. Results The incision healing rate [20.0%(18/90) vs 8.9%(8/90)] was statistically higher and persistent exudation time [(4.3±1.6) vs (2.5±1.4)d]significantly longer in the HBV infection group than in the non-HBV infection group (P<0.05). Multivariate logistic regression analysis[JP+1]showed that low albumin (OR=0.901,5%CI 0.848-0.957; P<0.001) and large volume of intraoperative bleeding (OR=4.572, 95%CI 1.945-10.746; P=0.010) were the main risk factors for poor incision healing in the HBV patients. ROC curve analysis indicated that the areas under curve (AUC) of albumin and intraoperative bleeding volume in predicting poor incision healing in these patients were 0.815 (95%CI 0.789-0.919, P<0.001) and 0.766 (95%CI 0.682-0.851, P<0.001), respectively, and the best cut-off points were 28.2g/L and 440 ml, respectively. Conclusion Compared with the non-HBV patients, the patients with HBV infection tend to have poor incision healing after hip arthroplasty, which is mainly related to low albumin and larger intraoperative bleeding.