Objective To investigate the therapeutic effect of plasma exchange (PE) and continuous hemofiltration (CVVH) on treating severe hepatitis patients with hepatic encephalopathy (HE). Methods Thirty-five severe hepatitis patients with HE were randomly devided into therapeutic group and control group. The patients in therapeutic group were given PE and CVVH treatment. All patients were given the same general therapy. We observed the therapeutic effects and the side effects in different HE stage patients. Results The effective rates for stage I, II, III, and IV HE patients in therapeutic group were 100%, 100%, 100%, and 50% respectively. The total effective rate in therapeutic group was 89%. And the effective rates of stage I,II,III,and IV HE patients in control group were 100%,33.4%,33.4%, and 0 respectively. The total effective rate in control group was 41.2%. There were significant differences in effective rates between the two groups (P<0.01). Conclusion The therapeutic effects of PE combined CVVH on treating severe hepatitis patients with HE is dependable and safe, especially for stage I, II and III HE patients. 