Abstract: Objective To investigate the prognosis and risk factors of sepsis complicated with acute kidney injury (AKI) in elderly patients. Methods From January 2014 to June 2017, 248 elderly patients admitted to our hospital for sepsis complicated with AKI were enrolled in our study. There were 150 males and 98 females with average age of (75.36±9.84) years. According to the 28 days survival of patients, they were divided into survival group (n=132) and death group (n=116). Univariate and multivariate logistic regression analysis was used to analyze the risk factors of poor prognosis. Results Of the 248 cases, 116 cases died, with the fatality rate of 46.8% (116/248). Intraabdominal infection occurred in 96 cases (38.7%) and lung infection in 77 cases (31%). Univariate and multivariate analysis showed that oliguriaOR, 2.048 (95% CI:1.512-3.096), extrarenal organ failureOR, 2.375 (95% CI:1.706-3.518), elevated blood urea nitrogen (BUN)OR, 1.658 (95% CI:1.163-2.705) and decreased albumin (Alb)OR, 0.714(95% CI:0.638-0.852) were independent risk factors for death in elderly patients with sepsis complicated with AKI (P< 0.05). Conclusion Oliguria, organ failure, elevated BUN and decreased Alb are independent risk factors for death in elderly patients with sepsis complicated with AKI. Early prevention and early detection should be done to reduce the risk of death.