Objective To investigate the clinical characteristics and diagnostic and treatment efficiency of acute pancreatitis (AP) for the elderly in recent years. Methods A retrospective analysis was performed on 102 elderly AP patients [≥60 years,(68.8±6.9)years, the aged group] admitted to our hospital from January 2014 to December 2016. Another 213 AP patients [<60 years,(46.7±4.4) years , the non-aged group] hospitalized in the same period served as controls. The causes of disease, ratio of severe AP, clinical manifestations, systematic and local complications, length of hospital stay after treatment, and mortality rate were collected and compared between the 2 groups. SPSS statistics 20.0 was used to perform the statistical analysis.Student’s t test or Chi-square test was employed for different data types. Results There were no differences in the ratios of systematic complications, local complications and severe AP between the 2 groups (P>0.05). The leading cause of AP was biliary tract disease, followed by hyperlipidemia, alcoholic cause and tumor, and the aged group had obviously higher ratios of biliary tract disease(70.6% vs 49.8%) and tumor (4.9% vs 0.0%), but lower ratio of hyperlipidemia (11.8% vs 20.2%) and alcoholic cause (6.9% vs 19.2%) when compared with the control group(all P<0.05). In clinical manifestations, the incidence of abdominal pain (84.4% vs 95.4%) was notably lower, while that of jaundice (66.7% vs 48.4%) was remarkably higher in the aged group than the non-aged group (P<0.05). There was no significant difference in the length of hospitalization time [(12.9±5.6) vs(11.7±4.6) d, P>0.05], but the mortality rate was significantly higher in the aged group (7.9% vs 1.4%, P<0.05). Conclusion The elderly AP patients have many basic diseases, and thus have high mortality rate. Clinicians should be cautious about biliary tract diseases and tumor for these patients.