Abstract: Objective To explore the characteristics of adverse drug reaction (ADR) in the elderly and provide evidences for rational drug use. Methods A retrospective analysis of ADR reports about elderly patients in the Army Adverse Drug Reaction Monitoring Center database was carried out. The data included the general condition of the patients, the type of drug, route of administration, dosage form, organ system involved, etc. Results Of the 41 176 ADRs identified in the elderly cases from 2009 to 2016, serious ADR was reported in 3 144 cases (7.64%), with male to female ratio of 1.30∶1, and they occurred most frequently in elderly cases with age of 60-79 years. Intravenously infusion was the most common seen route of ADR, which was adopted in 30 579 cases(74.26%). The most frequent ADRs were caused by anti-infective drugs (9 830, 23.87%) and anti-cancer drugs (4 601, 11.17%), with levofloxacin, moxifloxacin, oxaliplatin, gemcitabine, docetaxel as the leading drug varieties. The frequently involved organ systems were gastrointestinal system (10 379, 20.00%), skin and its accessories (9 729, 18.75%). Severe ADR included bone marrow suppression (495, 0.96%) and anaphylactic shock (241, 0.46%), mainly caused by gemcitabine, docetaxel, moxifloxacin. Conclusion ADR in elderly are more likely to involve multiple systems and organs. More attention should be paid to anti-infection drugs, anti-cancer drugs and other drugs caused serious ADR.