Background: The incidence of severe fever with thrombocytopenia syndrome (SFTS) has been steadily increasing over the years, accompanied by a persistently high mortality rate. Organ injury may serve as a potential contributor to poor clinical outcomes. This study aimed to summarize the characteristics and patterns of organ injury in patients diagnosed with SFTS. Methods: A retrospective analysis was conducted on patients with SFTS admitted to the First Affiliated Hospital with Nanjing Medical University (Jiangsu Provincial Hospital) between January 2023 and December 2024. During hospitalization, concurrent organ injuries were recorded and statistically analyzed. Logistic regression analysis was performed to evaluate the association between organ injury and prognosis. Furthermore, a nomogram was developed to predict discharge outcomes based on organ injury assessment in SFTS patients. Results: A total of 284 SFTS patients were enrolled in this study, among whom 252 (88.7%) exhibited signs of organ injury. Cardiac injury was most commonly observed. Multivariate logistic regression analysis revealed that pancreatic injury (OR=3.17, 95%CI: 1.28-8.00, P=0.012), renal injury (OR=8.64, 95%CI: 3.54-22.29, P<0.001), pulmonary injury (OR=4.82, 95%CI: 2.01-11.98, P<0.001), and cerebral injury (OR=3.25, 95%CI: 1.34-7.90, P=0.009) were independently associated with increased risk of in-hospital mortality in SFTS patients. The constructed nomogram demonstrated strong predictive performance for discharge outcomes. Internal validation using the bootstrap method (resampling=1000) showed an average area under the ROC curve of 0.937 (95%CI: 0.910-0.965). Conclusion: The majority of SFTS patients experienced concurrent organ injuries. Among these, pancreatic, renal, pulmonary, and cerebral injuries were significantly associated with increased mortality risk.