Background and Aims Pancreatic fistula is the most common complication after distal pancreatectomy (DP), and it is closely related to the patient's prognosis and outcome. Therefore, this study was conducted to investigate the occurrence of postoperative pancreatic fistula after DP and the risk factors, so as to provide a basis for developing the protective measures.Methods The clinical data of 99 patients undergoing DP for pancreatic tumors in the Second Affiliated Hospital of Air Force Medical University from January 2015 to February 2021 were retrospectively analyzed. The incidence rate postoperative pancreatic fistula was calculated, and relevant factors possibly causing postoperative of pancreatic fistula were determined by univariate and multivariate Logistic regression analysis.Results In the 99 patients after DP, the incidence of biochemical leakage was 34.3% (34/99), grade B pancreatic fistula was 18.2% (18/99), and grade C pancreatic fistula was 1.0% (1/99), respectively. The results of univariate analysis showed that age, operative time, pancreatic duct diameter and undergoing combined splenectomy or not were significantly related to postoperative pancreatic fistula (all P<0.05). Multivariate Logistic regression analysis results revealed that age <42 years (OR=0.955, 95% CI=0.914-0.998), operative time ≥ 253 min (OR=1.013, 95% CI=1.005-1.021) and combined splenectomy (OR=4.152, 95% CI=1.043-16.535) were independent risk factors for postoperative pancreatic fistula after DP (all P<0.05).Conclusion There is certain incidence rate of pancreatic fistula after DP. Age, operative time, and synchronous splenectomy are independent risk factors for pancreatic fistula after DP. Assessment of these factors may provide certain basis for predicting the risk of postoperative pancreatic fistula and implementing the prevention measures.