To analyze the operating room related causes and nursing countermeasures of pressure sores in surgical patients. Methods A total of 260 patients who underwent surgical treatment in our hospital from January to October 2022 were selected as the research subjects. The Braden pressure ulcer risk assessment scale was used to evaluate and compare the incidence of pressure ulcers in patients with different ages, weights, operation time, comorbidities, intraoperative postures, and fasting time. Results Among the 260 patients, 50 patients had pressure ulcer, with an incidence of 19.23%. The causes of pressure ulcer were related to the increase of age, the increase of weight, the prolongation of operation time, the combination of diseases, the position during operation, the prolongation of fasting time and other factors. The patients with pressure ulcer recovered after active and effective nursing measures. The results of this study showed that the causes of pressure ulcers in patients were positively correlated with age≥60 years, weight>75 kg, operation time>3 h, intraoperative prone or lateral position, and fasting time (P <0.01). The causes of pressure sores in patients were positively correlated with combined diseases (P <0.05). Conclusion The occurrence of pressure ulcers in surgical patients is related to the patient's age, weight, operation time, complicated diseases, intraoperative position, fasting time and other factors. In order to avoid the occurrence of pressure ulcers in operating room patients, effective and targeted nursing countermeasures should be adopted. For example, pay attention to the management of pressure ulcer injury, preoperative visit and assessment, reasonable adjustment of body position, standardized operation, pay attention to warm and dry, according to the regulations of handover, timely reporting of adverse events, so as to reduce the incidence of pressure sore in surgical patients as far as possible.