OBJECTIVE: To explore the clinical related factors of leucopenia induced by azathioprine in the treatment of inflammatory bowel disease (IBD). METHODS: Clinical information of 114 IBD patients were collected from our hospital during Jan. 2013-Mar. 2015. Steady concentration of AZA metabolite 6-thioguanine (6-TGNs) in red blood cell was determined by HPLC. The correlation of patient’s gender, age, diseases, AZA daily dose and blood concentration of 6-TGNs with leucopenia induced by AZA were investigated. The optimal critical value of leucopenia could be predicted with ROC curves. RESULTS: Among 114 IBD patients, 40 patients suffered from leucopenia (35.1%). There was no statistical significance in the proportion of leucopenia among patients with different age, gender, diseases and AZA daily dose (P>0.05). There was statistical significance in the proportion of leucopenia among patients with different concentrations of 6-TGNs (P<0.05). Mean blood concentration of 6-TGNs in leukopenia patients [(407.82±262.88)pmol/(8×108) RBC] was higher than patients with normal leukocyte level [(275.85±118.37) pmol/(8×108) RBC], with statistical significance (P<0.05). ROC curve predicted that the optimal critical value of leucopenia was blood concentration of 6-TGNs>291.04 pmol/(8×108)RBC. CONCLUSIONS: AZA induced leucopenia may be related to the concentration of 6-TGNs in red blood cell of IBD patients, and high concentration of 6-TGNs is risk factors of leucopenia. Clinicians can provide AZA individual treatment for IBD patient to reduce the occurrence of ?leucopenia according to routine blood test and the concentration of 6-TGNs.