| Summary: | Background: Patients undergoing dual antiplatelet therapy (DAPT) may experience recurrent gastrointestinal bleeding (GIB). We investigated the clinical characteristics and risk factors for recurrent non-variceal upper gastrointestinal bleeding (NVUGIB) in patients who had experienced NVUGIB while receiving DAPT. Methods: We enrolled patients diagnosed with NVUGIB while receiving DAPT between 2006 and 2020. Definite bleeding was confirmed by esophagogastroduodenoscopy in all NVUGIB patients. Results: A total of 124 patients were diagnosed with NVUGIB while receiving DAPT. They were predominantly male (<i>n</i> = 103, 83.1%), bleeding mostly from the stomach (<i>n</i> = 94, 75.8%) and had peptic ulcers (<i>n</i> = 72, 58.1%). After the successful hemostasis of NVUGIB, 36 patients (29.0%) experienced at least one episode of recurrent upper GIB, 19 patients (15.3%) died, and 7 (5.6%) patients had a bleeding-related death. Multivariate analysis showed that age was a significant factor for re-bleeding (odds ratio [OR], 1.050; 95% confidence interval [CI]: 1.001–1.102; <i>p</i>-value: 0.047), all-cause mortality (OR, 1.096; 95% CI: 1.020–1.178, <i>p</i> = 0.013), and re-bleeding-related mortality (OR, 1.187; 95% CI: 1.032–1.364, <i>p</i>-value: 0.016). In Kaplan–Meier analysis, the cumulative probabilities of re-bleeding, death, and bleeding-related death were significantly higher in patients aged 70 and older (<i>p</i> = 0.008, <0.001, and 0.009, respectively). Conclusions: Clinicians should be cautious about re-bleeding and mortality in elderly patients who experience NVUGIB while receiving DAPT.
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