Objective To investigate the postoperative self-rehabilitation in the elderly patients with total hip/knee arthroplasty (THA/TKA) and analyze the factors affecting their quality of life. Methods A total of 190 elderly THA/TKA patients in Qionghai People′s Hospital from January 2020 to January 2022 were enrolled as the study subjects. A questionnaire survey was conducted to statistically analyze the status quo of their at-home self-rehabilitation at 6 months after discharge. SPSS statistics 20.0 was employed to process the data. According to the data type, one-way analysis of variance, t test orχ² test was used for intragroup comparison. Multivariate linear regression analysis was used to analyze the factors affecting the postoperative quality of life of the elderly THA/TKA patients. Results Among the 190 questionnaires distributed, 179 valid responses were returned. The survey found that the average score of various dimensions of 36-item short form health survey (SF-36) in the 179 elderly THA/TKA patients was (54.41±8.77) points. The excellent and good rate of the hip was 40.00% (36/90) in the THA patients, and that of the knee was 42.70% (38/89) in the TKA patients. The overall self-care ability and social support were mostly at low and middle levels [(85.47% (153/179) and 88.83% (159/179)]. The incidence rates of anxiety and depression were 25.14% (45/179) and 27.37% (49/179) respectively. The compliance to the self-rehabilitation training was mostly good [(33.52% (60/179)] or poor [(46.37% (83/179)]. Multivariate linear regression analysis suggested that postoperative complications (β=-3.854; P<0.001) and depression (β=-0.277; P<0.001) had a negative predictive effect on the quality of life of the elderly THA/TKA patients, and that self-care ability (β=0.236; P<0.001), social support level (β=0.611; P<0.001) and compliance to the self-rehabilitation training (β=0.213; P<0.001) had a positive predictive effect, and the regression equation was significant (F=13.115; P<0.001). These variables together explained 50.60% of the variation in quality of life. Conclusion The overall self-rehabilitation in the elderly THA/TKA patients at 6 months after surgery is not good, and postoperative complications, self-care ability, social support, depression and compliance to self-rehabilitation training are independent factors affecting their quality of life. It is suggested to improve the quality of life of patients after surgery in these aspects.