Abstract: Objective To explore the related factors of diabetes insidious after Rathke cleft cyst surgery.Methods A total of 77 patients who were admitted to the Affiliated Hospital of Xuzhou Medical University and diagnosed with Rathke cleft cyst were selected. According to the presence of central diabetes insidious after surgery, the patients were divided into two groups: a diabetes insidious group(n=35) and a non-diabetes insidious group(n=42). Both groups were compared for the main clinical symptoms, surgical methods, operation time, inoperative cerebrovascular fluid leakage, cyst size classification, cyst contents and intracystic hemorrhage, cyst wall enhancement, cyst growth type, the degree of cyst wall resection, and secondary surgery after recurrence. Then, multivariate logistic regression analysis was used to analyze the risk factors of postoperative diabetes insidious.Results There were 35 of 77 patients with diabetes insidious after operation, accounting for 45.45%. According to univariate analysis, there were statistical differences in surgical methods, cyst growth types and the degree of cyst wall resection(P<0.05). Multivariate logistic regression analysis indicated that cyst growth type and the degree of cyst wall resection were the independent risk factors for diabetes insidious after Rathke cleft cyst surgery.Conclusions The degree of cyst wall resection and the type of cyst growth are closely related to diabetes insidious after Rathke cleft cyst surgery. Patients with nearly complete resection of the cyst wall, interstellar suprasegmental type and suprasegmental type have a high risk of diabetes insidious after surgery.