Objective To investigate the effects of immunotherapy on brainstem encephalitis (BE) and indentify the risk factors for early death in BE patients. Methods The clinical data of 67 BE patients who were admitted to The Second Xiangya Hospital and The Xiangya Hospital from 2003 to 2013 were respectively analyzed. The recovery time was analyzed by Kaplan-Meier method. The risk factors for early death in BE patients was analyzed by univariate and multivariate logistic regression analyses.Results No case was found to have recurrence during a mean follow-up period of one year. Fifty-three (79.1%) out of 67 BE patients achieved a complete remission with no residual symptoms, 3 patients (4.4%) had residual symptoms, and 11 patients (16.4%) died. BE patients who received a combination of IVIg and steroids had significantly faster alleviation of impaired consciousness than those in control group (P<0.05). The risk factors for early death were central high fever (P<0.05) and assisted mechanical ventilation (P<0.05).Conclusions A combination of IVIg and steroids can promote the recovery of impaired consciousness. Central high fever and assisted mechanical ventilation are the independent risk factors for early death in BE patients.