Objective To retrospectively analyze the clinical characteristics and risk factors for in-hospital death of the elderly patients with cardiorenal syndrome(CRS). Methods All over-65-year-old patients with eligible CRS according to Acute Dialysis Quality Initiative recommendations who discharged from general wards during January 2015 and June 2015 were identified from information system of our hospital. A retrospective study was performed on their medical records and clinical data, including age, sex, doctor visit causes, complicated diseases, hospitalization time and prognosis, vital signs at admission, admission blood routine and biochemical examination results, and treatment conditions, etc. Results There were 197 cases who were diagnosed with CRS. They were at an age of (78.91±7.94) years, and with a median hospital stay of 13(7, 25)d. There were 37 cases (18.78%) of CRS type Ⅰ, 59(29.95%) of type Ⅱ, 15(7.61%) of type Ⅲ, 26(13.20%) of type Ⅳ and 60(30.46%) of type Ⅴ. Diuretics were the most frequently prescribed agents (78.7%). Fifty-five patients underwent renal replacement therapy, and most of them were from the CRS type Ⅲ and Ⅳ groups. In-hospital death occurred in 38.10%(75 cases) of the patients. Logistic regression analysis showed that age, respiratory rate, white blood cell count (WBC), serum albumin, and renal replacement therapy were independent related factors for in-hospital death. Conclusion In the elderly with CRS, type Ⅰ and Ⅴ are more common, and type Ⅰ, Ⅲ and Ⅴ are of higher mortality. Age, higher WBC, faster respiratory rate and renal replacement therapy are independent predictive factors for death.