Objective To analyze the clinical characteristics and medication in the hospitalized elderly patients near the end of life. Methods Based on 1-year mortality prediction index, a total of 99 elderly patients (aged ≥70 years) were enrolled in the study, who were treated in the Department of Geriatrics, Peking Union Medical College Hospital from January 2015 to December 2017. Data were collected and analyzed of the characteristics of chronic diseases, geriatric syndrome, number of medications taken in hospital, number of medications taken out of hospital after medication reconciliation and number of medications taken for cardiovascular and cerebrovascular diseases. SPSS statistics 21.0 was used for data analysis. Depending on data type, Student′s t test or McNemar matching χ² test were performed for comparison. Results One-year mortality index for the 99 patients was 7-16 (9.8±2.3)score. The top three chronic diseases were malignant tumors (76.8%), hypertension (56.6%) and coronary heart disease (39.4%). The top three geriatric syndromes were polypharmacy (≥5 taken out of hospital; 72.7%), malnutrition or nutrition risk (72.7%) and constipa-tion (45.4%). The number of medications after medication reconciliation on discharge (7.4±3.9) increased significantly as compared with those used on admission (4.7±3.7; P<0.05), with increased use of symptomatic drugs such as vitamins, laxatives, analgesics, respiratory system drugs, antiacids, iron supplements and antidepressants and decreased use of antihypertensives (P<0.05). Of 48 patients with cardiovascular and/or cerebrovascular diseases, 25 (52.1%) were taking antiplatelet drugs and 32 (66.7%) were taking statins on discharge; 23 did not take antiplatelet drugs because of high risk of bleeding or active hemorrhage, and 16 did not take statins because of disability, high risk of associated adverse reactions, new myalgia or new abnormal liver function. Conclusion The rate of symptomatic drugs increases after medication reconciliation in the elderly patients near the end of life and strategies for cardiovascular diseases need to be formulated in accordance with the patient′s own condition.