【Background】A narrow pulse pressure(PP)is recognized as a predictor of active bleeding in trauma patients. Our study was aimed at evaluating the efficacy of PP as a predictor of shock in elderly patients with non-traumatic bleeding.【Design/Methods】This was a retrospective study of the data of patients registered in our hospital database from 2008 to 2020. Patients(65 years or older)with acute hemorrhagic gastric ulcers were included. The study patients were divided into two groups: the shock group(systolic blood pressure(SBP)<90mmHg within 90 minutes after arrival)and the non-shock group(no evidence of shock within 90 minutes after arrival). The demographic characteristics, vital signs on arrival, laboratory data, and clinical outcomes were compared between the two groups. Patients with shock on arrival were excluded.【Results】A total of 79 patients met our criteria and were divided into the shock group(n = 13)and non-shock group(n = 66). Significant differences in the PP and SBP were observed between the two groups. Next, the cutoff point of the PP for shock within 90 minutes of arrival was evaluated, and 48mmHg was identified as being significant(P = 0.005). Logistic regression analysis identified PP <48mmHg as an independent risk factor for shock.【Conclusions】Our study showed that the PP on arrival can predict the development of shock within the following 90 minutes in elderly patients with acute hemorrhagic gastric ulcers.