Objective To explore the clinical characteristics, treatment and prognosis of patients with aplastic anemia complicated with hepatitis B. Methods From Jan. 2010 to Dec. 2016, 50 patients with hepatitis associated aplastic anemia (HAAA) and 50 patients with severe aplastic anemia (SAA) in our hospital were taken as the clinical objects. The clinical manifestations, blood routine test, liver function, bone marrow smear, bone marrow biopsy, treatment and prognosis in HAAA group and SAA group were compared. Results There were varying symptoms such as anemia, bleeding, infection and so on in the two groups, but their differences were not statistically significant(P>0.05). When the hepatitis patients in the HAAA group were diagnosed as AA, their ALT and AST levels were significantly decreased(P<0.05). The WBC, PLT and ANC levels in the HAAA group were obviously lower than those in the SAA group(P<0.05). Compared with the SAA group, the granulocyte and hematopoietic area in the HAAA group were significantly decreased(P<0.05), but the fat and trabecular area in the HAAA group were increased significantly(P<0.05). Both groups were given stanozolol, hematopoietic growth factor and other bone marrow hematopoietic stimulating drugs, and related symptomatic treatment. The survival time of HAAA group was significantly shorter than that of SAA group(P<0.05). Conclusion There was no significant difference in the symptoms between AA complicated with hepatitis Band AA, all of which have varying degrees of anemia, bleeding, fever and other symptoms. The levels of WBC, PLT and ANC in patients with AA complicated with hepatitis B are significantly lower, and the bone marrow depression is more serious, which may lead to worse prognosis.