Objective To explore the influencing factors of return of spontaneous circulation(ROSC)in out-of-hospital cardiac arrest(OHCA)patients undergoing cardiopulmonary resuscitation(CPR),providing references for improving the success rate of resuscitation in OHCA patients.Methods A retrospective review of the medical records of 300 OHCA patients who underwent CPR was conducted,and patients were divided into an effective group of 42 cases and an ineffective group of 258 cases based on the resuscitation outcome.Clinical data of the two groups were compared,and multiple Logistic regression analysis was used to identify the influencing factors of ROSC in OHCA patients undergoing CPR.Results There was no statistically significant difference in gender,smoking,alcohol consumption,BMI,medical history(except for diabetes),and airway management type between the two groups(P>0.05).However,there were statistically significant differences in age,history of diabetes,witness status,initial rhythm type,epinephrine use,the start time of mild therapeutic hypothermia(MTH),emergency response time,and CPR start time(P<0.05).Multivariate analysis showed that age,witness status,epinephrine dosage,time of first epinephrine administration,start time of MTH,emergency response time,and CPR start time were all independent factors affecting ROSC in OHCA patients undergoing CPR(P<0.05).Conclusions The popularization of emergency knowledge,along with attention to epinephrine use,start time of MTH,emergency response time,and CPR start time in clinical practice,may improve the prognosis of OHCA patients.