Objective To investigate the real-world factors influencing the clinical outcome of Febrile neutropenia （FN） in oncology patients. Methods We conducted a retrospective analysis of clinical data from 130 FN patients admitted to our hospital between January 2020 and December 2022. The patients were categorized into three groups based on their clinical efficacy： cured group， effective group， and ineffective group. A comparison was made among the three groups regarding general data and laboratory examination results. Univariate and ordered multicategorical logistic regression analyses were performed to identify factors affecting the clinical efficacy of FN. Results The overall effective rate of FN in our hospital was 86.15%. Univariate analysis revealed statistically significant differences among the three patient groups regarding the duration of granulomatous defects， Physical Status Score （PS Score）， procalcitonin （PCT） levels， and timing of administration （P < 0.05）. Ordinal multicategorical logistic regression analysis demonstrated that patients with PS scores < 2， granulomatous defects lasting less than 7 days， and PCT levels below 0.5 ng/mL exhibited better clinical treatment outcomes. Conclusion In the management of FN， it is crucial to prioritize patients with high PS scores and elevated PCT levels while optimizing drug utilization to enhance clinical efficacy. Timely intervention should be implemented to address granulopathy and improve overall clinical outcomes.