Objective To observe the incidence of upper gastrointestinal bleeding in acute stroke.Methods We choosed the acute stroke patients hospitalized in Tiantan hospital and registered by Registry of Acute Cerebrovascular Events in China (RACE-CHINA), retrospectively analyze their medical history records.Results From August 2007 to July 2008, 1 408 acute stroke cases were registed in RACECHINA of Tiantan hospital, only 40 cases were finally diagnosed upper gastrointestinal bleeding, the incidence of acute stroke complicating with upper gastrointestinal bleeding was 2.84%.The mean years of age of upper gastrointestinal bleeding patients was 63±9.The incidence of upper gastrointestinal bleeding in cerebral hemorrhage was a little higher than cerebral infarction and subarachnoid hemorrhage(2.98% vs 2.75%; 2.98% vs 2.84%). Acute stroke with conscious disturbance, larger volume cerebral hemorrhage and cerebral infarction in vertebrobasilar systemhad a tendency to complicate with upper gastrointestinal bleeding. Upper gastrointestinal bleeding often occurred one or two weeks after acute stroke and persistenced about one week. The mortality of acute stroke was 7.0%, but when upper gastrointestinal bleeding appeared, the mortality of acutestroke would go up to 30%. Conclusion Upper gastrointestinal bleeding was severe complication of acute stroke and was one of the main risk factors which hinted unfavorable prognosis . Age, gender, stroke type, hemorrhage volume and conscious state were possibly the principal risk factors. We should think highly of thecomplication and enhance the prevention and management on it.