Objective To study the risk factors of acute upper gastrointestinal bleeding in hepatitis B virus(HBV)related cirrhosis.Methods A retrospective analysis was conducted on 258 patients with HBV related cirrhosis admitted between July 2016 and July 2021.They were divided into a bleeding group of 142 patients(bleeding group)and a non bleeding group of 116 patients(non bleeding group)based on whether they were complicated with acute upper gastrointestinal bleeding.The statistical software SPSS 22.0 was used for statistical analysis.The measurement data of normal distribution((x)±s)were tested by t test,and the counting data were expressed in rate(%)by x2 test;Logistic regression models were used for single factor and multivariate analysis.The difference was statistically significant with P<0.05.Results Univariate analysis showed that liver function grading,prothrombin time,left gastric vein flow,and hemoglobin were risk factors for HBV related cirrhosis with acute upper gastrointestinal bleeding(P<0.05);Multivariate analysis showed that Grade C liver function(0R=1.29,95%CI:1.06-1.90),prothrombin time>16s(OR=1.68,95%CI:1.14-2.28)and internal channel of left gastric vein(OR=2.08,95%CI:1.27-2.97)were independent risk factors for HBV related cirrhosis with acute upper gastrointestinal bleeding.Conclusion Among the risk factors for HBV related cirrhosis combined with acute upper gastrointestinal bleeding,liver function grading,prothrombin time,and left gastric vein internal circulation are independent risk factors.