Objective To evaluate the value of sTREM-1 in the early diagnosis and prognosis of patients with urosepsis after urologic endoscopy surgery. Methods One hundred and forty-eight patients, who were treated in Department of Urology, the Fifth Affiliated Hospital of Southern Medical University from January 2008 to December 2015, were divided into observation and control groups according to the infection status. Serum and urine levels of sTREM-1, and serum levels of PCT and CRP were analyzed retrospectively. Indicators including CRP, PCT and sTREM-1 were managed by receiver operating characteristic. The risk factors were analyzed by Cox proportional hazards analysis. The relevance between sTREM-1 and survival time of patients with urosepsis was analyzed by Person. Results Twenty-two patients died in the observation group, and the fatality rate was 29.7%. The serum levels of PCT and CRP increased at 1 d, 3 d and 7 d after the operation in the observation group, while the serum and urine levels of sTREM-1 increased at pre-operation, 1 h, 1 d, 3 d and 7 d. The sensitivity and specificity of sTREM-1 were higher than CRP, PCT. Serum and urine levels of sTREM-1 were independent risk factors for the prognosis of urosepsis, and were negative correlated with the prognosis. Conclusions The detections of serum and urine levels of sTREM-1 help the early diagnosis of urosepsis after urologic endoscopy surgery, and are independent risk factors for urosepsis.