Objective ·To investigate the level of stoma adaptation in patients with permanent enterostomy and its influencing factors. Methods ·In this cross-sectional study, 260 patients with permanent enterostomy from North Campus in Hongkou and South Campus in Songjiang of Shanghai General Hospital, Shanghai Jiao Tong University School of Medicine were recruited by convenience sampling approach from January to December, 2022. The level and the influencing factors of stoma adaptation were investigated by general information questionnaire, Chinese version of Ostomy Adjustment Inventory-20 (OAI-20), Hospital Anxiety and Depression Scale, Stoma Self-Efficacy Scale, Body Image Scale, and The Revised Dyadic Adjustment Scale. Statistical description used mean and standard deviation, frequency and percentage. T test, ANOVA, Spearman correlation and multiple linear regression analyses were preformed to explore the influencing factors of the level of stoma adaptation. Results ·The mean score of OAI-20 was (42.28±11.47). One-way ANOVA results showed the effects of registered residence (P=0.001), monthly income (P=0.000) and the ostomy-related complications (P=0.000) on the OAI-20 score were statistically significant. Spearman correlation analysis results showed that the OAI-20 score was positively correlated with stoma self-efficacy and marital adjustment score (r=0.713, P=0.000; r=0.645, P=0.000), but negatively correlated with anxiety and depression and body image score (r=-0.391, P=0.000; r=-0.523, P=0.000). Four of the eleven variables, ostomy-related complications, anxiety, self-efficacy of ostomy caring and marital satisfaction, were selected by the multiple linear stepwise regression analysis, and could explain 59.8% of total variance (P=0.000). Conclusion ·Most patients with permanent enterostomy have a low level of adaptation. Ostomy-related complications, anxiety, self-efficacy of ostomy caring and marital satisfaction are the main influencing factors of the level of stoma adaptation.