Objective: Gram-negative (G-) bacterial bloodstream infections are an important cause of sepsis, and sepsis-associated encephalopathy (SAE) is a common complication in sepsis patients. In this study, the incidence of SAE and the clinical outcome of these patients were summarized by reviewing the data of patients with G- bacterial bloodstream infection. Methods: The data of patients treated in the Emergency Medicine Center of the First Affiliated Hospital of Nanjing Medical University from January 2021 to June 2024 were reviewed. Patients with first blood culture positive G- bacteria after emergency visit, the patients were divided into SAE and non-SAE groups based on the SAE, and the propensity score matching (PSM) was used to plot the 30-day Kaplan-Meier (K-M) survival curves after adjusting for confounding factors between SAE and non-SAE groups. Results: A total of 207 patients were included in the study, and 92 (44.4%) patients experienced SAE with lower 30-day survival in the SAE group than in the non-SAE group (69.6% VS 97.4%, p <0.001). After matching the baseline data of the SAE and non-SAE groups using the PSM method, the 30-day survival rate was even lower in the SAE group (72.3% VS 100.0%, p <0.001), longer ICU stay [5 (0, 11) VS 0 (0, 5), p <0.001], proportion of invasive mechanical ventilation (MV) (40.0% VS 1.5%, p <0.001), proportion of continuous renal replacement therapy (CRRT) (32.3% VS 4.6%, p <0.001), the proportion of vasoactive drugs used (50.8% VS 15.4%, p <0.001), the K-M curve shows that the 30-day survival status of the SAE group was significantly worse than that of the non-SAE group (HR = 8.730, 95%CI: 3.443-22.14, p <0.001). Conclusions:SAE is a common complication in septic patients with G- bloodstream infections and causes a poor prognosis.