Objective To investigate the risk factors of deep vein thrombosis (DVT) as well as the association between acute traumatic coagulopathy (ATC) and DVT. Methods A retrospective observational study was carried out during the 12 month period in 2014 in emergency intensive care unit (EICU) of acute trauma center of Shanghai Jiao Tong University Affiliated Sixth People's Hospital. Data including age, gender, body mass index, injury severity score (ISS), mechanism of injury, injury sites, international normalized ratio (INR) and DVT of each patient were recorded. Patients were divided into ATC group and non-ATC group according to INR to compare the incidence of DVT. Results A total of 200 trauma patients were enrolled in this cohort. Sixty(30%) patients suffered from ATC. And eighty-seven patients (43.5%) were subjected to DVT. Patients with ATC had a significant higher incidence of DVT (71.7% vs. 31.4%, P<0.01). Multiple logistic regression revealed that patients in ATC group were highly associated with DVT in the magnitude of more than five fold (OR=5.74, 95%CI: 2.80-11.74, P<0.01) compared with non-ATC group. It was more significant (OR=9.80, 95%CI: 2.09-45.90, P=0.004) in patients with lesser severe trauma (9≤ISS<16). Meanwhile, spinal cord injury and long-bone fracture of lower extremities were independent risk factors for the development of DVT. Conclusions Severe trauma patients admitted to EICU within 24 hours post-injury have a high incidence of ATC. And those patients with ATC have a significantly higher incidence of DVT, especially in lesser severe trauma (9≤ISS<16). Spinal cord injury and long-bone fracture of lower extremities were independent risk factors for developing DVT. Key words: Trauma; Coagulopathy; Deep vein thrombosis; Injury site; Injury severity; Age; Body mass index; Risk factors