Objective To discuss the incidence,pathogenesis,prevention and prognosis of with acute cerebral infarction(ACI) patients complicated with multiple organ dysfunction syndrome in the elderly(MODSE).Methods A retrospective review of the clinical data of 152 elderly patients with ACI was conducted;36 patients with MODSE were defined as MODSE group,116 patients without MODSE were defined as control group.We comparatively analyzed the data of the two groups.Results In the 152 elderly patients with ACI,there were 36 cases complicated by MODSE,the incidence rate was 27.08%.The mortality of MODSE group was 45.35%;and the motality in control group was 4.35%;there was a significant difference of mortality between the two groups(P<0.01).We found that the organ easily affected were the lungs,cardiovascular system,brain,kidneys,gastrointestinal tract,liver successively.The more the organ involved,the higher the motality and the larger the infected area was.The main reasons of death was secondary respiratory failure,cardiac failure,cardiac arrest,cerebral lesion and cerebral hernia and kidney failure.Conclusion The incidence rate of elderly patients with ACI complicated by MODSE is higher with higher mortality.The main reasons lead to death are secondary respiratory failure,cardiac failure,cardiac arrest,cerebral lesion and cerebral hernia,and kidney failure.