Objective: Acute upper gastrointestinal bleeding is a common clinical emergency, which can be life-threatening in severe cases and should be paid close attention to Prompt diagnosis and treatment are critical, and previous guidelines recommend emergency gastroscopy within 24 hours. To explore whether gastroscopy within 12 hours after admission is a better time for AUGIB examination. Methods: A retrospective analysis was conducted on 244 patients who visited our emergency internal medicine department and received local anesthesia under gastroscopy from August 2021 to August 2024 (patients with AUGIB during gastroscopy examination). The patients were divided into two groups based on the time from emergency visit to local anesthesia under gastroscopy: the emergency gastroscopy group (within 12 h) and the elective gastroscopy group (after 12 h). The general clinical data, endoscopic diagnosis results, interventional embolization rate, surgical rate, blood transfusion volume, ICU hospitalization rate, average hospital stay, hospitalization cost, and mortality rate were compared between the two groups. Results: The hospitalization rate of intensive care unit (ICU) in the emergency gastroscopy group was higher than that in the elective gastroscopy group (P<0.05). There were no statistically significant differences in gender, age, past medical history, hospitalization cost, length of stay, blood transfusion rate, blood transfusion volume, emergency DSA rate, emergency operation rate, and mortality between the two groups (P>0.05). Conclusion: Emergency gastroscopy (examination time<12 h) is not a better time for gastroscopy in UGBI patients, does not benefit patients, and may increase the risk.