Abstract: Objective To explore the factors influencing the prognosis of severe hepatitis (SH) .Methods Clinical data of 365 patients with SH were analyzed retrospectively.Results (1) simple HBV infection is main cause of SH, superinfection (HBV+HCV and/or HBV+HEV) could make disease markedly heavier; (2) SH mainly prevalence on 20-60 years of age, the more elder, the higher fatality rates.Fatality rate was 74.5% in patients at age older than 60, the prognosis of SH had no relation to sexuality; (3) Fatality rate of SH was 54.8%.Fatality rate of acute SH, subacute SH and chronic SH was 83.3%, 64.3% and 53.0% respectively; (4) Prognosis of SH were closely related to the different levels of prothrombin active, total bilirubin, serium albumin, blood glucose, total cholesterin and bilirubin-enzyme segregation, had no relation to serum total bile acid; (5) 93.1% SH patients had complications (hepatic encephalopathy, spontaneous bacterial peritonitis, disorder of electrolyte, gastrointestinal hemorrhage, hepatorenal syndrome and other infections) , which were important factors influencing the prognosis of severe hepatitis (SH) , the more complications, the higher fatality rates.Conclusion Age, etiological factor, clinical type, biochemistry parameters, blood coagulation function and complications could influence survival rate of SH, the prognosis of SH had no relation to sexuality and serum total bile acid.