Acute gastric mucosal lesion (AGML) is a pathological change in the gastric mucosa marked by erosion, superficial ulceration and bleeding in varying degrees under stressful conditions such as severe trauma, major surgery, critical illness, severe psychological disorders, or direct stimulation by physical and chemical factors such as alcohol and drugs, which can lead to perforation of the digestive tract in severe cases and further deterioration of the systemic condition. AGML is not an independent disease, but a clinical syndrome with gastrointestinal damage as the main pathophysiological feature. From the clinical point of view, AGML can be divided into hemorrhagic gastritis and stress ulcer. The proportion of patients with upper gastrointestinal bleeding has increased from 7.7% to 13.7%. For critically ill patients admitted to the emergency room, endoscopic examination at 24 hours reveals that 75% to 100% of critically ill patients have gastric mucosal damage. In addition, the mortality rate of critically ill patients with gastrointestinal bleeding associated with gastric mucosal lesions is 50%-77%, which is four times higher than that of patients without gastrointestinal bleeding, and all of them have systemic tissue or organ failure, and AGML also prolongs the hospital stay of critically ill patients by 4-8 days. AGML also prolongs the length of stay in the hospital by 4 to 8 days. The Chinese Physicians Association Emergency Physicians Branch organized some emergency physicians to conduct a symposium on AGML with reference to domestic and international data and the specific situation in China, and reached a consensus to provide a basic standard and reference prognosis for emergency physicians in the diagnosis and treatment of AGML. The majority of gastric mucosal erosions and bleeding can heal and stop bleeding on their own, but in a few patients, mucosal erosions can develop into ulcers with increased complications, but usually respond well to medication. The prognosis of hemorrhage treatment is based on the following scores: Rockall score, Blatchford score, and Child-Pugh scale. Respiratory failure (mechanical ventilation for ≥48 h)? A variety of high-risk factors such as abnormal anticoagulant function predispose to AGML combined with severe bleeding, and appropriate preventive measures should be given once patients have high-risk factors? In the diagnosis, patients with AGML with high-risk underlying diseases or severe GI bleeding or even perforation are at risk AGML patients, who are susceptible to important organ function and at high risk of death, and should be given priority attention All AGML patients should be treated for control and removal of causative factors Gastric mucosal lesion treatment and gastric mucosal protection treatment, in which patients with abnormal anticoagulant function with GI bleeding are mostly seen in clinical practice ? For patients with risky AGML, emergency evaluation and management should be taken first, and organ function support should be provided. In conclusion, acid suppression therapy is the basis of treatment for all patients with AGML, and PPIs are recommended, while PPIs with low risk of drug action may be considered when there is little difference in the efficacy of several PPIs If drug therapy still fails to stop bleeding, endoscopic therapy and surgical treatment should be considered