Abstract: Objective To investigate the effects of physical activity and negative emotion on quality of life in elderly patients with chronic kidney disease (CKD). Methods General clinical data of 160 elderly patients with CKD treated in our hospital from January 2022 to December 2023 were retrospectively analyzed. Patients with mildly impaired GFR stage CKD1 to CKD2 were included in the control group (n=91), and patients with moderately and severely impaired GFR stage CKD3 to CKD5 were included in the observation group (n=69). After admission and before treatment, KDQOL-SFTM 1.3 was used to assess the patients' quality of life; the exercise ability of the patients was assessed by the National Health and Nutrition Examination Survey of the United States; the anxiety and depression states of the patients were assessed by Hamilton Anxiety Scale (HAMA) and Hamilton Depression Scale (HAMD). SPSS 20.0 statistical software was used to process the data, and T-test or χ2 test were used to compare the data between groups according to the data type, respectively. Pearson correlation was used to analyze the correlation between physical activity and negative emotion and quality of life in elderly patients with CKD. Result KDTA score of 66.29±7.15 points and SF-36 score of 52.35±6.19 points in the observation group were significantly lower than that in the control group, KDTA score of 80.61±9.36 points and SF-36 score of 82.99±9.03 points (t=10.974、25.442，P < 0.05).2MST, two-hand grip strength and 30s chair standing times in the observation group were significantly lower than those in the control group (t=1.550, 20.339, 14.128, 23.546, P < 0.05), and HAMA and HAMD scores in the observation group were significantly higher than those in the control group (t=34.996, 24.915, P < 0.05). Correlation analysis found that elderly patients with chronic kidney disease (CKD) KDTA score and physical activity in patients with 2 MST, hands grip strength, 30 s seats stand number was significantly positive correlation (r = 0.583, 0.457, 0.591, P < 0.05), and negatively correlated with HAMA scores, HAMD score (r = 0.616, 0.590, P < 0.05); SF-36 scores in elderly CKD patients were significantly positively correlated with 2MST, two-handed grip strength and 30s chair standing times during physical activity (r=0.801, 0.670, 0.806, P < 0.05), and negatively correlated with HAMA and HAMD scores (r=-0.824, -0.906, P < 0.05). Conclusion The quality of life score and physical activity of patients in the observation group were significantly lower than those in the control group, and the negative emotion score of patients in the observation group was higher. In addition, physical activity and negative emotion were positively and negatively correlated with quality of life, respectively, suggesting that clinical monitoring and intervention of physical activity and negative emotion should be strengthened to improve the quality of life of elderly CKD patients.