Objective To retrospectively analyze the clinical risk factors and prognosis of perioperative myocardial injury （MINS） in non-cardiac surgery patients admitted to the intensive care unit （ICU）. Methods A total of 478 postoperative patients admitted to the Department of Intensive Medicine， Minhang Hospital， Fudan University from Jan 2020 to Dec 2023 were selected. They were divided into MINS group （n=302） and normal group （n=176） based on whether myocardial injury occurred within 7 days after surgery. The differences in clinical characteristics between the two groups were compared， and risk factors for perioperative myocardial injury were identified. Risk factors for mortality in the MINS group were analyzed with 30-day mortality as the clinical endpoint. Results The prevalence of acute physiology and chronic health evaluation Ⅱ （Apache Ⅱ） score， coronary artery disease， and chronic kidney disease were all higher in the MINS group than those in the normal group， with statistically significant differences （P<0.05）. The proportion of emergency surgeries， co-infection， and perioperative hypotension were significantly different between the MINS group and the normal group （P<0.05）. Multivariate logistic regression analysis revealed that chronic kidney disease， emergency surgery， co-infection， and intraoperative and postoperative hypotension were risk factors for MINS occurrence. Prognostic analysis indicated that perioperative hypotension was a risk factor for 30-day mortality in MINS patients. Conclusion MINS is closely associated with patients’ underlying conditions， timing of surgery， and perioperative hypotension status， and especially perioperative hypotension affects the final outcomes.