OBJECTIVE: To study the protective effects of Polygonum hydropiper extract on acute gastric mucosal lesion (AGML) in rats. METHODS: 48 rats were randomly divided into normal group (normal saline), model group (normal saline), positive group (ranitidine hydrochloride, 0.05 g/kg), P. hydropiper extract low-dose, medium-dose and high-dose groups (2.7, 8.1, 24.3 g/kg by crude drug), i.g. for consecutive 7 d, once a day. Except for normal group, other groups were given absolute ethyl alcohol to induce AGMI model after 1 h of last administration. 1.5 h after modeling, gastric mucosal lesion index of rats was calculated; the pathological changes of gastric tissue in rats were observed; nuclear factor E2 related factor 2 (Nrf2) content and SOD activity in gastric tissue of rats were determined by ELISA. RESULTS: Compared with normal group, the gastric mucosa of model group was damaged obviously, there was blood capillary rupture in submucosa, gastric mucosal lesion index was increased significantly(P<0.01); Nrf2 content and SOD activity were significantly decreased in gastric tissue of rats (P<0.05 or P<0.01). Compared with model group, gastric mucosal lesion of rats was relieved to different extent; in positive group, P. hydropiper extract medium-dose and high-dose groups, gastric mucosal lesion index was decreased significantly (P<0.05), and Nrf2 content and SOD activity were increased significantly(P<0.05 or P<0.01). CONCLUSIONS: P. hydropiper extract has good protective effect on absolute ethyl alcohol-induce AGMI, the mechanism of which may be associated with raising Nrf2 content and enhancing SOD activity in gastric mucosal tissue.