Objective: To investigate the clinical effect of endoscopic titanium clamp hemostasis combined with lansoprazole in the treatment of peptic ulcer bleeding (PUB). Methods: 82 patients with peptic ulcer bleeding (PUB) admitted to our hospital from April 2022 to April 2024 were selected as the study objects. The patients were divided into control group and study group by random number table, with 41 cases in each group. The control group was treated with lansoprazole + colloidal bismuth pectin capsule; On the basis of control group, the study group combined with endoscopic metal titanium clamp hemostasis treatment. The hemostatic effect, coagulation function [prothrombin time (PT), activated partial prothrombin time (APTT), fibrinogen (FIB) level], perioperative rehabilitation, inflammatory factor levels [interleukin-6 (IL-6), tumor necrosis factor-α (TNF-α) level] and complications of the two groups were analyzed and compared. Results: The hemostatic effective rate of the study group was significantly higher than that of the control group (P < 0.05). After 1 week of treatment, APTT and PT in both groups were significantly shorter than before treatment, and FIB was significantly higher than before treatment. APTT and PT in the study group were significantly shorter than those in the control group, and FIB was significantly higher than that in the control group (P < 0.05). The time of vaginal conversion, hematemesis and abdominal pain relief in the study group were significantly shorter than those in the control group (P < 0.05). There was no significant difference in length of stay between the two groups (P > 0.05). After 1 week of treatment, the levels of IL-6 and TNF-α in both groups were significantly lower than before treatment. The levels of IL-6 and TNF-α in the study group were significantly lower than those in the control group (P < 0.05). There was no significant difference in the incidence of complications between the two groups (P > 0.05). Conclusion: Endoscopic metal titanium clamp hemostasis combined with lansoprazole in the treatment of PUB patients can improve the therapeutic effect, improve coagulation function, promote perioperative rehabilitation, reduce the level of inflammatory factors, and have high safety.