Objective To investigate the etiology, characteristics of upper gastrointestinal bleeding (UGIB) in China, and to investigate the main causes of different population. Methods Literature on the causes of UGIB were retrieved and screened according to strict inclusion and exclusion standards. Results A total of 15 733 UGIB patients were enrolled in the study. The most common causes of UGIB were duodenal ulcer (31.2%) , gastric ulcer ( 15.2% ) , acute gastric mucosal lesions (AGML) ( 12. 0% ) , cancer (11.7%), and esophageal varices (11. 3% ). The incidences of duodenal ulcer, gastric ulcer, AGML, esophageal varices, cancer were 32. 3% , 15.1% , 12. 1% , 7. 2% , and 12. 5% before 2006, and 29.7% , 15.4%, 11.1%, 15.3%, and 10. 9% after 2006. The ratio of male to female was 3.25 : 1. The most com- mon causes of UGIB in older patients were gastric ulcer, cancer, AGML, duodenal ulcer,esophageal vari- ces, while those in children were duodenal ulcer, gastric ulcer and AGML. Conclusion Peptic ulcers, AGML, cancer and esophageal varices were the most common causes of UGIB in China. The causes of UGIB have changed significantly in the past 5 years (P 〈 0. 01 ). Key words: Gastrointestinal hemorrhage; Gastroscopy; Syndrome differ pathogen fact; Epide- miology