Objective To analyze the causes of acute non- variceal upper gastrointestinal bleeding (ANVUGIB) in the elderly patients. Methods Clinical data of 233 patients (＞60 years old) with ANVUGIB treated in our department from January 2011 to December 2015 were collected and analyzed retrospectively. Results The age was (74.38±8.86) years in the cohort, ranging from 60 to 96 years. Among these 233 patients, the most common cause was peptic ulcer, accounting for 47.6% (111 patients, including 49 cases of gastric ulcer, 43 cases of duodenal ulcer, and 19 cases of complex ulcer), followed by digestive tumors (74 patients, 31. 8%) and acute gastric mucosal lesion (20 patients, 8.6%). In the analysis of risk factors, 28.8% cases of gastrointestinal bleeding were related with nonsteroidal anti- inflammatory drugs (NSAIDs) and anticoagulants, and gender was also one of risk factors. Conclusion Peptic ulcer is the most common cause of ANVUGIB in the elderly patients. NSAIDs and anticoagulants are most common risk factors for gastrointestinal bleeding in the cohort.