Objective To investigate the efficacy and safety of continuous venous-venous hemofiltration (CVVH) in the treatment of multiple organ failure in the elderly (MOFE). Methods Clinical data of 33 elderly patients with MOFE who underwent CVVH treatment in our hospital from January 2010 to December 2020 were collected and retrospectively analyzed in this study. According to their survival time longer than 15 d or not, they were divided into survival group (n=18) and death group (n=15). Their age, number of failed organs, blood biochemical indicators, arterial blood gas parameters, treatment methods, death time and other indicators were analyzed. SPSS statistics 22.0 was used for statistical analysis. Results All patients had femoral vein catheterization, and 4 cases experienced catheter infection. There were no significant differences in age, serum levels of urea nitrogen, creatinine, electrolytes and pro-brain natriuretic peptide, arterial blood pH value, and residual alkali between the two groups (all P>0.05). Obvious differences were seen in lactic acid level [(2.32±1.17) vs (5.00±4.35) mmol/L], 24-hour urine volume [(501.17±229.62) vs (220.33±191.68) ml] and number of failed organs [(3.33±1.14) vs (4.33±1.15), all P<0.05]. Urea nitrogen [(34.27±13.54) vs (15.77±9.15) mmol/L], serum creatinine [(347.57±170.22) vs (165.55 ± 89.32) μmol/L], pro-brain natriuretic peptide [(2 128.27±1 416.08) vs (1 181.86±1 305.17) pmol/L], blood potassium [(4.78±1.03) vs (4.12±0.56) mmol/L], arterial blood pH value [(7.28±0.12) vs (7.33±0.12)] were statistically significant before and after CVVH treatment (all P<0.05). But no such differences were found in blood sodium, calcium, phosphorus, residual alkali and lactic acid before and after treatment (P>0.05). Conclusion CVVH treatment is significantly helpful for improving the prognosis, reducing the heart loading, accelerating the removal of small molecule toxins, and maintaining the balance of electrolytes and pH value in the elderly patients with MOFE.