Objective: Chronic micro-aspiration secondary to gastroesophageal reflux (GER) may play a role in the pathogenesis and natural history of idiopathic pulmonary fibrosis (IPF). Our goal was to investigate the relationship between chronic anti-reflux therapy and survival time in patients with IPF. Methods: Case reports comprising data involving gastroesophageal reflux diagnosis and treatment were analyzed to investigate the relationship between GER-related variables and survival time in an identified cohort of patients with IPF from Weihai Municipal Hospital. Results: Of the 69 eligible patients, 34 used varying doses of chronic anti-reflux medications, and 35 were non-users. Chronic anti-GER use was defined as >= 6 months non-prn use of any antacid drug and/or gastrointestinal motility drugs at study entry; non-users showed < 6 months of use or none. Chronic symptomatic use of anti-GER medications was significantly associated with longer survival time in unadjusted analysis (HR = 0.410, P = 0.003; HR = 0.524, P = 0.017). After adjustment, chronic use of GER medications was an independent predictor of longer survival time (HR = 0.229, P < 0.001). Conclusions: Chronic use of anti-reflux therapy is an independent predictor of longer survival time in patients with IPF.