Objective To determine the effect of an intelligent alert and management system introduced into intensive care units (ICU) on the management efficiency of hand hygiene compliance (HHC) for health care workers (HCWs) and on the indicators of nosocomial infection. Methods Surgical general ICUs from an upper first-class hospital was chosen and the study was implemented in two stages. Baseline stage: the HHC rates of ICU HCWs were investigated in secret by trained observers and the nosocomial infection indicators were also collected and analyzed. Intervention stage: the intelligent hand hygiene alert and management systems, which based on radiofrequency identification technology, have been deployed to collect ICU HCWs’ hand hygiene behaviors before or after patient contact and analyze the HHC rates automatically. The nosocomial infection indicators were also collected and analyzed. The HHC rates of ICU HCWs, nosocomial infection rate, the detection rate of multi-drug resistant bacteria and the consumption of alcohol-based hand rub were compared before and after the intervention. Results Compared with before intervention, total HCC rate increased significantly after intervention (69.52% vs 38.27%,P<0.05), and the HHC rates of HCWs in different positions were all significantly higher than before intervention (P<0.05). The HHC rates have been rising month by month and remained at high levels since intervention. The nosocomial infection rate (7.81% vs 35.56%, P<0.05) and the detection rate of multi-drug resistant bacteria (20.0% vs 40.63%) decreased, and the consumption of alcohol-based hand rub increased significantly［189.33 vs 36.69% ml/(bed·day)］. Conclusion The hand hygiene intelligent alert and management system not only realizes the intelligent reminds and effective management of HCWs’ hand hygiene behaviors, but also improves the hospital infection indicators.