Abstract: Objective To investigate the related influence factors of neonatal transfusion-associated necrotizing enterocolitis （TANEC）. Methods Clinical data of neonates with necrotizing enterocolitis （NEC） treated by surgery were retrospectively analyzed. All participants were divided into the TANEC and non-TANEC groups. Clinical characteristics, maternal conditions, laboratory test results, intraoperative conditions and clinical prognosis were subject to univariate and multivariate Logistic regression analyses. Related factors of TANEC were identified. The predictive values of these factors were determined by the receiver operating characteristic （ROC） curve and the area under the ROC curve （AUC）. Results A total of 51 infants were enrolled in this study, including 13 cases in the TANEC group and 38 in the non-TANEC group. Univariate analysis showed statistically significant differences in birth weight, Apgar-1 score, gestational age, number of transfusions, patent ductus arteriosus and hemoglobin level between two groups （all P < 0.05）. Multivariate Logistic regression analysis revealed that the number of transfusions and hemoglobin level were the related factors for the incidence of TANEC （both P < 0.05）. ROC curve verified that the AUC of the number of transfusions was 0.882 （95% CI 0.794-0.969）, 0.857 （95% CI 0.747-0.968） for hemoglobin level, and 0.907 （95% CI 0.822-0.992） for the two combined, respectively. Conclusion The number of blood transfusion and hemoglobin level are associated with the occurrence of TANEC, and the combination of these two can better predict the incidence of TANEC.