Objective To analyze the impact of endocrine metabolism on impulsive aggressive behavior of patients with bipolar disorder， and to provide a basis for the future prevention and treatment of such diseases. Methods The medical records of 106 patients with bipolar disorder admitted to Xinjiang Uiger Municipal People's Hospital from April 2018 to December 2019 were retrospectively analyzed as research group， and clinical data of 109 healthy people from the physical examination center during the same period were collected as control group. The endocrine metabolism status were detected. According to whether they had impulsive aggression behavior， the patients with bipolar affective disorder were divided into impulsive aggression behavior group and non-impulsive aggression behavior group. The correlation between endocrine metabolism indicators and their relationship with impulsive aggression behavior were analyzed respectively. Results The levels of ACTH and TSH in the research group were（ 29.56±2.75） pg/ml and（ 3.60±1.22） μIU/ml respectively， which were lower than those in the control group. The levels of cortisol， triiodothyronine and thyroxine were （102.95±6.41） nmol/L，（ 1.51±0.64） ng/ml，（ 82.66±16.34） ng/ml respectively， which were higher than those in the control group（ P＜ 0.05）. Among 106 patients， 23 patients had impulsive aggressive behavior. The levels of ACTH and TSH in the impulsive aggressive behavior group were（ 27.85±2.03） pg/ml and（ 2.64±1.03） μIU/ml respectively， which were lower than those in the non-impulsive aggressive behavior group. The levels of cortisol， triiodothyronine， and thyroxine were（ 103.86±4.36） nmol/L，（ 1.71±0.60） ng/ml， and（ 89.69±16.12） ng/ml respectively， which were higher than those in the non-impulsive aggressive behavior group（ P ＜ 0.05）. Correlation analysis found that there were significant correlations between the various endocrine metabolism related indicators（ P＜0.05）. Regression analysis results showed that abnormal endocrine metabolism was an influencing factor of impulsive aggressive behavior in patients with bipolar disorder（ OR=1.197，1.776，1.024， 1.903，7.414， all P＜ 0.001）. The ROC curve was drawn and showed that the AUC results of the risk of bipolar disorder combined with impulsive aggressive behavior predicted by each endocrine metabolism index were all higher than 0.80， which had certain predictive value. Conclusions Abnormal endocrine metabolism may be the influencing factor of impulsive aggression in patients with bipolar disorder. It can be considered to predict the risk of impulsive aggression in patients with bipolar disorder by detecting endocrine metabolism status， so as to guide the early risk prediction and reasonable intervention of impulsive aggressive behavior in patients with bipolar disorder.