Objective To analyze clinical manifestations and renal histopathological typing in the elderly patients with renal diseases. Methods A retrospective study was made of the elderly patients who underwent renal biopsy in Xijing Hospital of Air Force military Medical University from January 2016 to December 2020 in their epidemiological characteristics, clinical manifestations and renal histopathological typing. SPSS statistics 19.0 was used for statistical analysis. Results Among the 4 386 patients who underwent renal biopsy, there were 360 elderly renal diseases patients (male 231, female 129). The average age was (70.04±4.59) years. Nephrotic syndrome (42.22%, 152/360)was the most common indication of renal biopsy. The most common histopathological diagnosis was still primary glomerular disease (62.78%, 226/360), of which membrane nephropathy was the most common(59.29%, 134/226), followed by IgA nephropathy (19.91%, 45/226) and minimal-change disease(12.39%, 28/226). The incidence of secondary glomerular disease was 31.11%(112/360), diabetic nephropathy accounts for the first place (23.21%, 26/112), followed by anti-neutrophil cytoplasmic antibody-associated small-vessel vasculitis and amyloidosis, both accounting for 19.64%(22/112). Conclusion The clinicopathological manifestations of elderly patients with renal disease have their own characteristics. For the elderly patients with renal disease of unknown etiology, renal pathological biopsy should be performed as soon as possible, which is helpful to make a clear diagnosis and early treatment and improve the prognosis of the patients.