Objective To investigate the clinical characteristics and pathogenesis of wasp sting in the elderly in order to improve the rescue success rate. Methods Two hundreds and twenty-one patients suffering from acute wasp sting admitted in Zhushan County People’s Hospital from January 2009 to December 2013 were enrolled in this study, and assigned into different groups according to their ages, the elderly group (n＝56, ≥60 years old) and non-elderly group (n＝165, ＜60 years old). Their incidences of multiple organ dysfunction, prognosis and clinical outcomes were analyzed and compared. Results After acute wasp sting, the incidences of liver and cardiovascular dysfunction were 55.36% and 32.14%, respectively in elderly group, while in non-elderly group, the incidences were 56.97% and 36.97% respectively. There were 35 patients developing to multiple organ dysfunction syndrome (MODS) in elderly group, accounting for 62.50%, and 94 patients in non-elderly group (56.97%), but no significant difference was seen between the 2 groups (P＞0.05). The mortality was 62.50% in elderly group (2 cases) and 56.97% in non-elderly group (2 cases, P＞0.05). Conclusion The most commonly damaged organs are liver and cardiovascular system in either elderly or non-elderly patients following acute wasp sting. And, there is no obvious difference in the incidence of MODS and mortality between the 2 different aged groups.