Objective To investigate plasmapheresis on coagulation and fibrinolysis in severe chronic hepatitis patients. Methods Twenty patients with severe chronic hepatitis received plasmapheresis in a total of 65 times. We observed the changes of coagulation and fibrinolysis in these patients before and after the plasmapheresis treatment. Results After the treatment, clinical symptoms improved in all patients. Prothrombin time,kaolin partial thromboplastin time (KPTT), international normalized ratio (INR), fibrinogen and fibrinogen degradation products (FDP) decreased. Plasma thromboplastin antecedent (PTA), coagulation factors Ⅴand Ⅶ increased (P<0.05 or 0.01). Conclusion Plasmapheresis is effective to improve the coagulation and fibrinolysis functions in patients with severe chronic hepatitis.