Abstract: Objective To analyze the changes of disease spectrum in elderly inpatients during recent ten years. Methods Medical records of patients aged 60 years or more from internal medicine or geriatric departments in our hospital from 2005 to 2014 were retrospectively collected and analyzed. Results A total of 30 267 older inpatients with average age of (82.84±9.17) years were included, most of their age ranged from 80 to 99 years old. The top three first-listed diagnosis included circulatory system diseases, neoplasms and respiratory system diseases, among which coronary heart disease and lower respiratory tract infection were the most frequent causes for the elderly hospitalization. The proportions and ranks of cerebral infarction, chronic gastritis and lung cancer were rising. Conclusion The ageing problem in population poses great challenges for health-care system. Lower respiratory tract infection, ischemic heart disease and lung cancer are the main causes of hospitalization in the elderly patients of our hospital.