Aspiration is one of the most common clinical problems in elderly,characterized by a high prevalence, serious harm and difficult diagnosis. Long-term repeated aspiration can lead to dehydration, malnutrition, aspiration pneumonia, and other adverse consequences. Age, disease, treatment, medication, feeding, and other factors jointly contribute to the occurrence of aspiration in the elderly, and a variety of instruments and bedside screening methods can be used to assess the risk of aspiration. In this paper, we reviewsed influencing factors and risk assessment of aspiration in the elderly, aiming to provide preferences for early detection, scientific evaluation, and timely intervention of aspiration in the elderly.