Multiple organ dysfunction syndrome in the elderly(MODSE) is quite different from MODS in other populations. China, now, is experiencing population aging, and it will certainly be a critical problem in the coming decades. As the forefront of hospital, the emergency department is facing a growing number of the elderly patients in seeking first aid. Emergency physicians have to make fully understanding of MODSE, and know very well its etiology, clinical features, and diagnosis and treatment principles. What’s more, the doctors should keep profound and active caution in their mind that the elderly would be very weak when they get MODSE, and must provide more timely, cautious and careful diagnosis and treatment for the elderly patients suspicious for MODSE or confirmed as MODSE than for younger population. Only in this way, it is possible to gain some time for follow-up treatment and guarantee successful rescue for the elderly.