Objective To investigate the clinical characteristics and risk factors of allergic rhinitis (AR) in the elderly. Methods A total of 236 AR patients treated in Beijing Royal Hospital of Integrative Chinese Medicine from January 2018 to December 2022 were enrolled into the study group. According to the age, they were divided into a young and middle-aged group (aged 18-59 years old; n=102) and an elderly group (age≥60 years old; n=134). A control group enrolled 160 elderly volunteers treated in the same hospital during the same period, who matched the elderly AR group in age and gender but without allergic disease. Firstly, the young and middle-aged AR group and the elderly AR group were compared in the clinical characteristics, and then a binary logistic regression model was used to analyze the factors affecting the AR onset in the elderly in reference to the control group. SPSS 19.0 was used for data analysis. Comparison between two groups was performed usingχ²test. Results There were no statistically significant differences in the gender ratio and incidence peak among the AR patients in different age groups. The rate of positive allergen tests in elderly AR patients (32.09%, 43/134) was lower than that in the young and middle-aged AR group (68.63%, 70/102) and the difference was statistically significant (P<0.05). The AR type in elderly group was mostly intermittent (53.73%, 72/134) and the severity was mostly mild (63.43%, 85/134); the AR type in young and middle-aged group was mostly persistent (60.78%, 62/102), and the severity was equally mild (50.00%, 51/102) and moderate-to-severe (50.00%, 51/102), the differences being statistically significant (P<0.05). The incidence of throat discomfort/cough in elderly AR patients (29.85%, 40/134) was lower than that in young and middle-aged group (46.08%, 47/102) with statistically significant difference (P<0.05), but there were no statistically significant differences in other accompanying diseases. Binary logistic regression analysis indicated that pet ownership, exposure to occupational dust, family history of AR, and history of asthma were independent factors affecting the onset of AR in the elderly (OR=1.752,2.036,1.992,3.916; P<0.05). Conclusion Compared with the young and middle-aged patients, the elderly AR patients have lower positive rate of allergen tests and milder clinical manifestations and disease. It is clinically necessary to pay attention to the screening and diagnosis of AR in the elderly to reduce the rates of the missed diagnoses and misdiagnoses. It is also necessary to emphasize the screening for AR in the elderly with clinical symptoms and high risk factors such as pet ownership, exposure to occupational dust, family history of AR and history of asthma.