Objective To analyze the related factors for cardiovascular events (CVE) in the elderly patients with ventilator-associated pneumonia (VAP). Methods The clinical data of 297 elderly VAP patients admitted in our hospital from January 2017 to September 2020 were collected and retrospectively investigated. They were divided into CVE group and non-CVE group according to whether CVE occurred, and the related factors that may affect the occurrence were analyzed. SPSS statistics 25.0 was used for statistical analysis. Chi-square test or student′s t test was performed for data comparison between 2 groups depending on date types. Logistic multivariate regression analysis was applied for further analysis. Results Among the 297 elderly VAP patients, 104 (35.02%) experienced CVE, and 193 (64.98%) did not. In the elderly VAP patients with CVE, new onset heart failure, new onset heart failure+atrial tachycardia, and deterioration of heart failure were quite common. Logistic regression analysis showed that the history of chronic cardiovascular disease, acute physiology and chronic health evaluation scoring system score, blood glucose, serum creatinine, procalcitonin were independent risk factors for CVE in elderly VAP patients (P<0.05). The timing of extubation (immediately), body position (semi-recumbent position), arterial blood pH value and antibiotics selection based on drug sensitivity test were the independent protective factors for CVE in elderly VAP patients (P<0.05). Conclusion Attention should be paid to the elderly with the history of chronic cardiovascular disease and in critical condition. Anti-infective treatment, blood glucose control, protection of kidney function, and maintenance of acid-base balance can reduce the incidence of CVE in elderly VAP patients.