Background Behcet's disease (BD) can involve any site of the alimentary canal. There has been research concerning intestinal BD. Nevertheless, the entire digestive tract not yet been studied extensively. Therefore, the purpose of study was to describe the prevalence, location, clinical features and possible risk factors of BD with gastrointestinal tract ulcer.Methods This was a cross-sectional observational study that included 1232 consecutive BD patients who routinely underwent endoscopy upon

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... heir wishes. The clinical symptoms, endoscopic findings, and histologic features of BD with gastrointestinal ulcer and negative Helicobacter pylori (Hp) were identified.Result We found that 22.16% (273/1232) Hp-negative BD patients had ulcers of the alimentary tract. At presentation, 61.54% (168/273) patients were asymptomatic. The numbers of BD patients with gastrointestinal ulcers isolated to upper gastrointestinal tract, small bowel, ileocecal region, ascending colon, transverse colon, descending colon, sigmoid colon and rectum were 84, 4, 106, 2, 3, 1, 2 and 8, respectively. The rest involved at least two of these intestinal segments. Only one patient suffered from total gastrointestinal tract involvement. Inflammation was the most common histopathologic feature 77.60% (142/183). The 273 BD patients with gastrointestinal ulcer were at greater risk of having archenteric symptoms (OR = 0.108, P < 0.001), fever (OR = 0.235, P = 0.001) and high CRP level (OR = 0.991, P = 0.019). Uveitis may be a protective factor for gastrointestinal ulcer in patients with BD (OR = 2.480, P = 0.002). Conclusion BD could affect the upper gastrointestinal tract independently. Endoscopy should be conducted in all patients in whom a diagnosis of BD is entertained, especially in patients with higher CRP and fever. While, BD patients with uveitis correlates negatively with gastrointestinal involvement.