Abstract: Objective To analyse the clinical and therapeutic features as well as laboratory findings in bullous pemphigoid with non-bullous lesions as initial manifestation. Methods Clinical data on 34 cases of bullous pemphigoid with non-bullous lesions as initial manifestation were retrospectively analyzed. Results The male to female ratio was 1.83 ∶ 1, with a mean age of onset at 59.79 ± 15.63 years. Before typical bullae appeared, patients presented with erythema, papules, papulovesicles, plaques, wheals, nodules, or erythema multiforme-like lesions, with the most common lesions being erythematous papules and plaques （occurring in 35.29% of these patients）. Conclusions Among these patients, nearly 1/3 displayed various skin lesions at the onset; simultaneous erythematous papules and plaques are the most common initial manifestation.