Objective To analyze the quality of life and the influencing factors in the elderly patients with comorbidities. Methods A retrospective analysis was made of clinical data of 150 elderly comorbid patients admitted to the Geriatric Department of Union Wuhan Red Cross Hospital from February 2022 to February 2023. The patients′ chronic disease status was recorded, and their quality of life was evaluated using a concise quality of life scale. The quality of life among the elderly comorbid patients was compared in gender, age, marital status, education level, monthly income, residential regions, severity of comorbidities, number of comorbidities, and cognitive functions. The data were processed using SPSS 22.0. According to the data type, independent sample t test, one-way analysis of variance, orχ² test was used for inter-group comparison. Unconditional logistic stepwise regression analysis was used to identify risk factors affecting the quality of life of the elderly comorbid patients. Results The common chronic diseases in 150 elderly patients were hypertension, diabetes and respiratory diseases. Of all the patients, 44 (29.33%) had two comorbid chronic diseases, 77 (51.33%) had three comorbid chronic diseases, and 29 cases (19.33%) had more than three chronic diseases. The elderly comorbid patients aged ≥70 years, having an income <3 000 yuan/month, living alone, having severe comorbidities, having more than 3 comorbidities and having cognitive dysfunction had significantly lower life quality scores than those aged < 70 years, having an income ≥3 000 yuan/month, not living alone, having mild to moderate comorbidities, having 2 or 3 comorbidities, and having no cognitive dysfunction. The differences were statistically significant (t=6.276,2.785,2.599,19.519,233.834,4.254; P<0.05). Multivariate logistic regression analysis showed that age ≥70 years (OR=5.245,95%CI 1.667-16.483), monthly income <3 000 yuan (OR=1.975, 95%CI 1.307-2.984), living alone (OR=4.881,95%CI 1.526-15.612), severity of comorbidities (OR=3.748,95%CI 1.600-8.780), number of comorbidities more than 3 (OR=1.997,95%CI 1.371-2.909), and cognitive dysfunction (OR=1.520,95%CI 1.136-2.034) were the risk factors affecting the quality of life of the elderly comorbid patients. Conclusion The quality of life of the elderly comorbid patients is affected by many factors such as cognitive function and disease status and needs to be improved.