Abstract: Objective：To investigate the predictors of severe Gullain-Barré syndrome (GBS) based on single center. Methods：A total of 245 cases of inpatients with GBS between May 1998 and December 2017 were selected at the Department of Neurology, Affiliated Hospital of Xuzhou Medical University. The inpatients were divided into two groups based on Hughes scale, and the gender, age, residence attribute, prodrome infection history, neurological symptoms, and complications were compared between the two groups. The factors with statistically significant differences in the univariate analysis were included into the multivariate analysis, and the predictors of severe GBS were analyzed. Results：Among the 245 patients, 81 cases (33.1%) in the mild group and 164 cases (66.9%) in the severe group. Logistic regression analysis showed that age ≥40 years old (OR=2.729), initial symptom with upper limb (OR=4.372), bulbar paralysis (OR=6.468), autonomic nervous dysfunction (OR=5.166), degraded tendon reflex (OR=5.213) and complications (OR=3.507) were predictors of severe GBS. There was no chance to be severe GBS when patients had no predictor. The chance to be severe GBS was 49.2%, 61.4%, and 93.5% when patients had 1, 2, 3 predictors, respectively. And the chance to be severe GBS was 100% when patients had 4 to 6 predictors. Conclusions：The age≥40 years old, initial symptom with upper limb, bulbar paralysis, autonomic nervous dysfunction, degraded tendon reflex, and complications were predictors of severe GBS. As the number of prediction factors increases, the possibility of GBS aggravating increases.