Objective To investigate the risk factors of non-obstructive gastric retention before endoscopic retrograde cholangiopancreatography (ERCP) in patients with biliopancreatic disease. Methods The matched case-control study included 109 patients with non-obstructive gastric retention before ERCP as the case group, and 218 patients without gastric retention as the control group. The patients"" medical records including comorbidities, preoperative medication and laboratory indicators were compared between the two groups. Multivariate conditional logistic regression models were subsequently used to determine the risk factors for non-obstructive gastric retention before ERCP. Results Logistic regression revealed that the jaundice (OR=12.359, P<0.001), opiates use (OR=3.009, P=0.001), somatostatin use (OR=2.445, P=0.033), fasting hyperglycemia (OR=1.513, P=0.045), hypokalemia (OR=4.634, P=0.001) and hyponatremia (OR=1.805, P=0.023) were independent risk factors for non-obstructive gastric retention before ERCP in patients with biliopancreatic disease. Conclusion Except for gastrointestinal obstruction, jaundice, opiates use, somatostatin use, fasting hyperglycemia, hypokalemia and hyponatremia are all risk factors for gastric retention in patients with biliopancreatic disease. Comprehensive evaluation and early intervention for patients showing these risk factors are needed.