Objective To analysis the risk factors of postoperative bleeding of endoscopic submucosal dissection (ESD) for early gastrointestinal cancer. Methods A retrospective study was performed on the data of 430 patients (449 lesions) with early gastrointestinal cancer undergoing ESD in Fujian Provincial Hospital Digestive Endoscopic Center from June 2008 to February 2015 and in Fujian Provincial Hospital South Branch Digestive Endoscopic Center from May 2015 to April 2018. Patients with postoperative bleeding were compared with those without postoperative bleeding on the basis of general conditions, endoscopic performance, postoperative pathology and so on to analysis the risk factors for postoperative bleeding of ESD. Results Among the 430 cases (449 lesions)of early gastrointestinal cancer undergoing ESD, 16 cases (3.7%) had postoperative bleeding. According to whether the occurrence of postoperative hemorrhage,patients were divided into bleeding group (n=16) and not bleeding group (n=433). Univariate analysis suggested that whether had hypertension was statistically significant between the two groups (χ2=4.793, P=0.029), while patients age (t=0.465, P=0.642), gender (χ2=0.035,P=0.642), whether to have diabetes (χ2=0.647, P=0.421),whether to have coronary heart disease (P=1.000), lesion size (t=1.598, P=0.111),whether two or more lesions (P=1.000), lesion site (χ2=6.183,P=0.289),operation time (t=1.335, P=0.201), pathological grading (χ2=0.687, P=0.709),and lesion infiltration depth (χ2=0.134, P=0.714) were not statistically significant between the two groups. Logistic regression analysis showed that hypertension (OR=3.358, 95%CI: 1.227-9.186, P=0.018) was an independent risk factor of bleeding after ESD for early gastrointestinal cancer. Conclusion Hypertension is closely related to postoperative bleeding following ESD for early gastrointestinal cancer.Patients with hypertension are at a greater risk of bleeding after ESD.