Objective To study the association of gastric hyperplastic polyps (GHPs) and autoimmune metaplastic atrophic gastritis (AMAG). Methods A retrospective analysis was conducted on data regarding 56 GHPs patients who underwent endoscopic resection at Beijing Friendship Hospital, Capital Medical University from January 2011 to June 2017, including 17 patients with neoplasia and 39 patients without neoplasia. The characters of GHPs in serology, gastroscopic manifestation and pathology were analyzed. Results The data of patients including 34 females and 22 males were collected in the study. The age was 61.88±9.01 years. The increase rate of fast serum gastrin was 50.0% (28/56), the positive rate of serum gastric parietal cell antibody (PCA) was 62.5% (35/56), the rate of anemia was 37.5% (21/56), and the negative rate of Helicobacter pylori was 64.3% (36/56). Compared with the patients with negative serum PCA, the patients with positive serum PCA were mostly female (P=0.034), prone to hypergastrinemia (P<0.001), anemia (P=0.001), especially iron deficiency anemia (P=0.044), and multiple GHPs (P=0.019). There were 108 GHPs in 35 PCA positive patients, GHPs were more distributed in the gastric fundus and corpus (91/108, 84.3%) than in antrum (17/108, 15.7%, P=0.005). There were 63 GHPs in 21 anemia patients, 54 (85.7%) GHPs located in the gastric fundus and corpus, and 9 (14.3%) GHPs in antrum (P=0.075). There were total 142 GHPs in 56 patients, 73.2% GHPs (104/142) were pedunculated, 69.0% (98/142) were “strawberry-like” polyps. Among 17 patients of GHP with neoplasia, there were 6 high differentiated adenocarcinomas, 2 moderate adenocarcinomas, 3 high grade dysplasia, and 6 low grade dysplasia. Conclusion GHPs are associated with AMAG. GHP with AMAG is probably one of the reasons of neoplastic transformation.