Objective: To summarize the status of native liver survival (NLS) in the early stage after Kasai procedure in patients with biliary atresia and to analyze the factors associated with postoperative death or liver transplantation. Methods: From May 2020 to May 2024, 114 cases of biliary atresia underwent Kasai surgery in Children’s Hospital of Nanjing Medical University. Nine cases were lost to follow-up, leaving 105 cases included in the study, with a follow-up period ranging from 12 to 60 months. Kaplan-Meier survival analysis was used to summarize the characteristics of NLS after Kasai surgery, and univariate and multivariate Cox regression models were employed to identify associated factors for postoperative death or liver transplantation. Results: As of May 2025, 105 patients were followed up for 12 to 60 months, with a median follow-up time of 33 months. Among these, 41 cases died or underwent liver transplantation, resulting in a total NLS rate of 61.0%. Of these, 35 cases died or underwent liver transplantation within the first year after the Kasai procedure, accounting for 85.4% of all deaths or liver transplants. The Kaplan-Meier survival curve estimated an average NLS time of 38.4±2.51 months after Kasai surgery, with an actual NLS rate of 66.7% and an estimated 2-year cumulative NLS rate of 59.6%. The estimated 3-5 year cumulative survival rate was consistent with the 2-year cumulative survival rate. Univariate and multivariate Cox regression models revealed that the preoperative Liver stiffness measured by ultrasound（LSM） and a jaundice clearance time exceeding 3 months postoperatively are two independent associated factors with death or liver transplantation after the Kasai procedure (HR[95%CI]=1.031[1.001,1.064],p=0.049; HR[95%CI]=6.394[3.141,13.015], p<0.001). Among the 105 patients, 66 (62.9%) developed cholangitis within 3 months postoperatively, with 18 (27.27%) developing postoperative cholangitis within the first month. The jaundice clearance rate in patients who developed cholangitis within the first month was lower than in those who did not (50.0% vs 77.1%, χ2=4.546, p=0.031). Conclusion: Most deaths or liver transplants occur within the first year after Kasai, and stable NLS is typically achieved by the second year post-Kasai. The preoperative LSM and postoperative time to jaundice clearance are independent associated factors for postoperative non-NLS in children with biliary atresia. The preoperative LSM was higher than 11.6KPa, and the jaundice clearance time was greater than 3 months would significantly reduce the rate of early NLS. Postoperative cholangitis within the first month after Kasai surgery can reduce the jaundice clearance rate within three months post-surgery.