Objective To understand chronic pain self-efficacy in the elderly patients with lumbar disc herniation (LDH) and to explore its influencing factors. Methods From March 2018 to December 2018, a total of 231 elderly patients with LDH were sampled from 3 hospitals in Xi′an, who were to be treated with removal of nucleus pulposus, bone graft fusion and internal fixation. An analysis was made using Chronic Pain Self-efficacy Scale (CPSS), self-rated anxiety scale, illness behavior questionnaire and visual analog scale. Statistical analysis was performed using SPSS statistics 17.0, and multivariate linear stepwise regression analysis was performed for influencing factors of self-efficacy. Results The chronic pain self-efficacy in the patients with LDH scored 41-74 (60.33±8.88)points. Of the three dimensions, the highest score was for pain management [(3.05±0.46)points], and the lowest was for physical function [(2.63±0.35)points]. Multivariate linear stepwise regression analysis showed that anxiety, level of illness behavior, severity of pain in the lumbar and legs, comorbidity of other chronic diseases, and degree of education were closely related to the self-efficacy level of the elderly LDH patients (P<0.05). Conclusion Patients with LDH have a moderate overall chronic pain self-efficacy. Self-efficacy is the highest for pain management and the lowest for physical function. Anxiety, illness behavior, pain level, comorbidity of other chro-nic diseases are risk factors of the chronic pain self-efficacy in the patients with LDH, and high education level is its protective factor.