Abstract: OBJECTIVE To investigate the clinical characteristics of the severe hepatitis complicated with spontaneous bacterial peritonitis (SBP) and analyze the distribution of pathogens so as to provide guidance for clinical treatment. METHODS A total of 75 severe hepatitis patients complicated with spontaneous bacterial peritonitis who were treated in the hospital from Jun 2010 to Jun 2015 were enrolled in the study, and the clinical characteristics of the enrolled patients were analyzed. The pathogens isolated from the ascites specimens were identified by using WITEK-2 Compact, the predisposing factors for the SBP were observed, and the statistical analysis of data was performed with the use of SPSS15.0 software. RESULTS Of the 75 patients, 71 (94.67%) had abdominal distension. The ascites routine examination showed that 44 (58.67%) patients were with the white blood cell counts more than 0.5×10⁹/L, and 65 (86.67%) patients were with the polymorphonuclear leukocyte counts more than 0.25×10⁹/L. The ascites specimens were cultured positive in 47 patients, with the positive rate of 62.67%. The major predisposing factors for the SBP included the respiratory system, digestive system, and urinary system infections. Totally 35 strains of pathogens were isolated from the submitted ascites specimens of the 75 patients, of which 11 (31.43%) were gram-positive bacteria, and 24 (68.57%) were gram-negative bacteria; Enterococcus spp was dominant among the gram-positive bacteria, accounting for 17.14%; Escherichia coli was the predominant species of the gram-negative bacteria, accounting for 31.43%. CONCLUSION It is necessary to actively prevent the respiratory system and digestive system infections and pay high attention to the rapid increase of ascites and effect of diuretics so as to confirm and treat the SBP as early as possible and improve the clinical efficacy.