Objective：To investigate the risk factors of refractory reflux esophagitis（RRE）. Methods：A total of 212 patients with reflux esophagitis（RE） who received proton pump inhibitors（PPIs） treatment for 8 weeks were enrolled including 93 RRE patients（43.9%）with ineffective treatment and 119 non-refractory reflux esophagitis（NRRE） patients（56.1%） with effective treatment. Clinical data （gender，age，body mass index（BMI），family history，endoscopy grading，anxiety and depression status） were collected and analyzed statistically. Results：There were statistical differences between RRE group and NRRE group in age，BMI，duration of disease，family history（P<0.05） while no significant difference in gender（P ＞0.05）. There were statistically significant differences in anx－iety and depression grading between RRE group and NRRE group before and after treatment（P<0.05） while no statistically significant difference in endoscopy grading（P ＞0.05）. Logistic regression analysis showed that middle-age，obesity，family history of RE，long dis－ease duration and clinical symptom and severe anxiety and depression were higher risk factors for RRE. Conclusion：RRE is related with age，BMI，family history，anxiety and depression status and disease duration. Middle-age，obesity，family history of RE，long dis－ease duration，severe anxiety and depression are risk factors of RRE. There is no parallel association between clinical severity and gas－troscopic severity for patients with RRE.