Background and study aim: The aim of this study was to determine the prevalence, characteristics, and risk factors of erosive esophagitis and Barretts esophagus in an adult Chinese population without gastroesophageal reflux symptoms. Patients and methods: Between March 2006 and February 2007, consecutive individuals aged between 18 and 75 years, who underwent routine upper endoscopy as part of their regular medical examination were recruited. Demographic and medical information were collected. Erosive esophagitis was defined endoscopically as visible breaks of the distal esophageal mucosa. Barretts esophagus was diagnosed endoscopically and confirmed histologically. Silent GERD was defined when erosive esophagitis and/or Barretts esophagus were present in an individual without reflux symptoms. Results: Among the 2580 individuals included, erosive esophagitis and Barretts esophagus were found in 4.3% (n=110) and 1.0% (n=27), respectively. In individuals with erosive esophagitis and Barretts esophagus, 33.6% and 40.7%, respectively, were asymptomatic. Thus, the prevalence of erosive esophagitis and Barretts esophagus in individuals without GERS was 1.6% and 0.5%, respectively, giving an overall prevalence of silent GERD of 2.0% (46/2270). Multivariate analysis identified that male sex (odds ratio [OR]=2.87, 95% confidence interval [CI] 1.246.66; P=0.014), hiatus hernia (OR=9.68, 95%CI 5.0017.95; P<0.001), and alcohol consumption (OR=3.17, 95%CI 1.446.97; P=0.004) were positively associated with erosive esophagitis, whereas Helicobacter pylori infection (OR=0.37, 95%CI 0.140.98; P=0.046) was negatively associated with erosive esophagitis. Alcohol consumption (OR=5.32, 95%CI 1.5513.33; P=0.008) was positively associated with Barretts esophagus in asymptomatic individuals. Conclusion: In this cohort of the adult Chinese population without reflux symptoms, the prevalence of erosive esophagitis and Barretts esophagus is 1.6% and 0.5%, respectively, with an overall prevalence of silent GERD of 2.0%. Male sex, hiatus hernia, and alcohol consumption are positively associated with erosive esophagitis, whereas a negative association exists for H. pylori infection. Alcohol consumption is positively associated with Barretts esophagus.