A prospective study was carried out in a burn unit of a tertiary care referral centre in North India. Patients with 20-70% TBSAB were enrolled. Seventy-one patients developed 59 hospital-acquired infections (HAI); the infection density being 36.2 infections per 1000 patient days. Invasive wound infections were the commonest (33), followed by blood stream infections (22), urinary tract infections (3) and pneumonia (1). Infection contributed to 75% of observed mortality. On logistic regression analysis, infected patients were more likely to die as well as stay longer in the hospital as compared to non-infected patients. Infected patients also had more central venous lines inserted. The mortality was related to percent TBSAB. Thirteen out of 18 patients who had TBSAB more than 60% died as compared to 5 out of 31 with TBSAB less than 40%. Staphylococcus aureus, Pseudomonas aeruginosa and beta-hemolytic streptococci (BHS) were the most frequent organisms causing hospital-acquired infection. Except for BHS all other organisms were highly drug resistant. Better compliance with hand washing and barrier nursing techniques, stricter control over disinfection and sterilization practices and usage of broad spectrum antibiotics, and reduction of the environmental contamination with S. aureus are required to reduce the HAI rates.