Objective <p>Catheter-associated urinary tract infections (CAUTIs) are common healthcare-related infections in intensive care units (ICUs). This study investigated the risk factors for CAUTIs in critically ill patients.</p> Methods <p>This study was a single-centre, retrospective, matched case-control study of patients undergoing indwelling catheterization in the ICU from December 1, 2016, to October 31, 2021. Patients with catheterizations were matched 1:4 with controls that were hospitalized in the ICU during the same period (with a difference in admission time of no more than two months).</p> Results <p>CAUTI occurred in 18 of 403 patients, with an infection rate of 3.7/per 1000 catheter days. Repeat catheterization of the urinary catheter (OR = 10.09) and days of antibiotic use (OR = 0.13) were independent risk factors for CAUTI (<i>P</i> &lt; 0.05). A total of 31 pathogen strains were detected in urine samples from 18 CAUTI patients. The main pathogens were Gram-positive bacteria (<i>n</i> = 13, 41.9%), fungi (<i>n</i> = 10, 32.3%) and Gram-negative bacteria (<i>n</i> = 7, 22.6%). CAUTI was associated with an increase in hospitalization days by 26 days and an increase in total hospitalization cost of ¥160,000 (<i>P</i> &lt; 0.001).</p> Conclusion <p>CAUTIs pose an economic and health burden for ICU patients. Repeat catheterization and longer use of antibiotics are to be avoided as much as possible.</p>