Objective To describe the clinical characteristics of epistaxis patients in Tianmen and to evaluate the impact of air pollution levels and meteorological factors on the risk of inpatient surgery, providing evidence for clinical prevention and intervention；Methods A retrospective study was conducted among patients diagnosed with epistaxis at Tianmen First People’s Hospital from January 1, 2022, to December 31, 2024. Data collected included sex, age, visit time, and inpatient surgical status. Air pollution and meteorological data for the same period were obtained from the Hubei Provincial Department of Ecology and Environment and the National Oceanic and Atmospheric Administration. Descriptive statistics and Spearman correlation analyses were performed for environmental factors. Univariate and multivariate logistic regression analyses were conducted using inpatient surgery as the outcome variable;Results After excluding missing data, a total of 9803 cases (96.37%) were included. The average concentrations of PM2.5, PM10, and O? were 36.07μg/m3, 71.17μg/m3, and 103.18μg/m3, respectively, while the mean values of SO?, CO, and NO? were 7.06μg/m3, 0.73mg/m3, and 16.41μg/m3. The average Air Quality Index (AQI) was 75.85. During the same period, the average temperature was 18.48℃, average wind speed 4.19m/s, and median humidity 56.8%. The daily average number of epistaxis visits was 9.36, with a peak of 50 cases. Spearman correlation analysis showed the strongest correlation between PM2.5 and PM10 (r=0.91). Overall, pollutants were negatively correlated with average temperature, humidity, and wind speed (r=-0.18 to -0.64). The number of visits was positively correlated with average temperature and humidity (r=0.32-0.40) and negatively correlated with air pollutants (r= -0.26 to -0.04). Case numbers showed a pattern of higher incidence in spring and summer and lower in autumn and winter. AQI classification indicated most patients were exposed to “good” and “moderate” air quality levels (7892 cases). Multivariate regression analysis showed that PM2.5, average temperature, and average wind speed reduced the risk of hospitalization for surgery (OR=0.988, 0.952, 0.954), while SO? (OR=1.089) and CO (OR=1.762) increased the risk. Moderate (OR = 3.064) and severe pollution (OR=4.348) significantly raised the probability of surgery;Conclusion Epistaxis in Tianmen City shows distinct temporal and demographic characteristics, with air pollution and meteorological factors significantly affecting the risk of hospitalization and surgery. Controlling SO? and CO levels and improving overall air quality may help reduce the incidence of epistaxis and the associated surgical risks.