The effects of the inclination angle and wear of the ship stern bearings on the water film pressure have been studied in view of the rapid wear of the water lubricated bearings at the ship stern. Firstly, the water film thickness in the presence of the inclination angle is calculated by using the empirical equation for the bearing wear thickness proposed by Dufrane, which is introduced into the Reynolds equation for the calculation of the water film pressure. The results show that the inclination angle and wear will change the distribution of the water film, especially the wear will make the inlet section of the water film pressure shorter and the pressure bearing region narrower. Under the same load conditions, the maximum water film pressure slowly increases with the increase of the inclination angle. However, it first slowly increases and then rapidly increases with the increase of the wear. The maximum water film pressure increases by seven times when the inclination angle and wear increase to half of the maximum allowable values in the specification. And the position of the maximum water film pressure moves towards to the end with smaller eccentric distance and larger wear, indicating that the wear rate of the damaged end will further increase.