Objective To investigate the association between exposed cardia glands and gastroesophageal reflux disease and its risk factors. Methods Prospectively enrolled patients who underwent gastroscopy at Chengde Central Hospital in Hebei Province from December 2023 to March 2024. Patients with exposed cardia glands who met the inclusion and exclusion criteria were assigned to the observation group,?while those without exposed cardia glands during gastroscopy but meeting the same inclusion and exclusion criteria were assigned to the control group during the same period. The general demographic factors and endoscopic characteristics of the two groups were compared to analyze the relationship between exposed cardia glands and gastroesophageal reflux disease. Results Univariate analysis demonstrated statistically significant differences between the observation group and the control group in the following factors: body mass index, waist circumference, smoking , drinking, tea, coffee, preference for irriting food, sleeping posture, use of calcium channel blockers , Helicobacter pylori infection, peptic ulcer disease, and gastroesophageal reflux disease(P<0.05).Binary logistic regression analysis identified the following independent risk factors for exposed cardia glands: waist circumference (P=0.012, OR=1.070, 95% CI: 1.015 - 1.129), drinking (P=0.003, OR=2.166, 95% CI: 1.293 - 3.631), preference for irriting food (P=0.048, OR=1.611, 95% CI: 1.004 - 2.582), right-side sleeping posture (P<0.001, OR=3.219, 95% CI: 1.696 - 6.108), use of calcium channel blockers (P<0.001, OR=3.871, 95% CI: 2.263 - 6.621), Helicobacter pylori infection (P<0.001, OR=3.512, 95% CI: 1.953 - 6.317), and gastroesophageal reflux disease (P<0.001, OR=2.905, 95% CI: 1.829 - 4.613). Conclusion Exposed cardia glands are correlated with gastroesophageal reflux disease. Affected by reflux, exposed cardia glands may fuse and progress. Independent risk factors for exposed cardia glands include waist circumference, drinking, preference for irriting food, right-side sleeping posture, use of calcium channel blockers, and Helicobacter pylori infection.