Objectives To explore different factors (clinical presentations and laboratory investigations ) between the severe and mild Guillain-Barré syndrome (GBS) in southeast China ,and to find the predictors of severe GBS. Meth?ods Retrospective analysis was conducted on 101 cases of patients with GBS admitted to our Hospital from Jan. 2006 to Nov. 2015, who were divided into mild and severe groups according to Hughes scale. The different factors were compared between these two groups such as age, sex, precursor infection factors, the initial symptoms, bulbar dysfunction, cranial nerves involvement, autonomic nervous dysfunction, peripheral nerve axonal damage to find the predictors for the severe GBS. Results Severe GBS more frequently presented with non-paresthesia as initial symptom (P<0.001) , bulbar dysfunc?tion (P<0.001), cranial nerves involvement (P=0.025), autonomic nervous dysfunction (P=0.018), motion system involve?ment (P = 0.004) and peripheral nerve axonal damage (P<0.001). After multivariable logistic regression analysis, we found that the axon damage(P=0.008, OR=4.632), bulbar dysfunction(P=0.010, OR=10.420), and cranial nerves in?volvement(P=0.047, OR=0.076)were the independent risk factors for sever GBS. Conclusion Axon damage, bulbar dys?function, and cranial nerves involvement might be significant predictors of sever GBS.