Objective To analyze the relationship between disease uncertainty, social support and quality of life in the elderly patients with coronary heart disease. Methods A retrospectively analysis was made of the clinical data of 150 elderly patients with coronary heart disease in the Department of Cardiology of First Affiliated Hospital of Xinjiang Medical University from April 2022 to March 2023, including general demographic data, Mishel uncertainty in illness scale (MUIS), social support scale and quality-of-life scale scores. SPSS statistics 26.0 was used for data analysis. Measurement data were compared using independent sample t test or analysis of variance. Pearson correlation was used to analyze the correlation between disease uncertainty, social support and quality of life in the elderly patients with coronary heart disease, and logistic regression was used to analyze the influencing factors of quality of life in the elderly patients with coronary heart disease. Results The 150 elderly patients with coronary heart disease scored (119.76±12.85) points for disease uncertainty, (61.83±5.42) points for social support, and (63.91±6.28) points for quality of life. There were significant differences in the quality-of-life scores of elderly patients with coronary heart disease in the aspects of education level, per capita monthly family income and treatment payment method (P<0.05). The quality of life was negatively correlatied with disease uncertainty score (r=-0.501; P<0.05), and positively with social support score (r=0.457; P<0.05). Education level (OR=2.824,95%CI 1.343-5.935), household monthly income per capita (OR=2.751,95%CI 1.345-5.626), treatment payment method (OR=2.702, 95%CI 1.379-5.292), disease uncertainty (OR=3.111,95%CI 1.474-6.565), and social support (OR=2.933,95%CI 1.451-5.928) were the influencing factors of quality of life in the elderly patients with coronary heart disease. Conclusion The quality of life of elderly patients with coronary heart disease is low and is related to disease uncertainty and social support. Interventions can betargeted at the influencing factors of quality of life of the elderly patients with coronary heart disease to improve their quality of life.