Objective To investigate the effect of compound diisopropylamine dichloroacetate combined with ornithine aspartate in the treatment of non-alcoholic steatohepatitis (NASH) in the elderly. Methods A total of 95 elderly patients with NASH hospitalized in Sichuan Forestry Central Hospital from January 2019 to December 2019 were prospectively recruited and then randomly divided into control group and observation group, with 46 cases in each group. The control group was treated with atorvastatin, and the observation group was treated with compound diisopropylamine dichloroacetate combined with ornithine aspartate on the basis of atorvastatin. The indicators of liver function, blood lipid, ultrasonic imaging score, NASH activity score (NAS), inflammatory factors and adverse reactions were compared between the 2 groups. SPSS statistics 26.0 was used for data analysis. According to the data types, independent sample t test or Chi-square test was employed for intergroup comparison. Results After treatment, the observation group had significantly lower indicators in liver function, including alanine aminotransferase [(53.29±6.84) vs (65.73±7.25) U/L], aspartate aminotransferase [(34.61±4.27) vs (45.73±5.12) U/L] and γ-glutamyltransferase [(41.25±3.59) vs (64.74±5.52) U/L] (all P<0.05), decreased blood lipid indicators, such as total cholesterol [(4.12±0.64) vs (4.87±0.66) mmol/L], triglyceride [(1.42±0.31) vs (1.63±0.42) mmol/L] and low-density lipoprotein cholesterol [(2.27±0.61) vs (3.04±0.59) mmol/L] (all P<0.05), reduced ultrasound imaging score [(6.18±1.34) vs (7.25±1.46)] and NAS score [(3.27±0.54) vs (3.85±0.73)](both P<0.05), and lower inflammatory factors, that is, serum interleukin-6 [(109.43±11.87) vs (129.75±10.96) μg/L], tumor necrosis factor-α [(51.26±6.05) vs (63.18±6.72) μg/L) and transforming growth factor-β [(6.03±1.92) vs (8.45±2.21) μg/L) (all P<0.05) when compared with the control group. There was no significant difference in the incidence of adverse reactions between the 2 groups (P>0.05). Conclusion Compound diisopropylamine dichloroacetate combined with ornithine aspartate shows effective efficacy in the adjuvant treatment of NASH in the elderly, and has a certain clinical value in clinical practice.