Objective To analyze the factors affecting urinary control recovery in the elderly patients with prostate cancer after radical prostatectomy. Methods A total of 131 elderly prostate cancer patients who underwent radical prostatectomy were selected as the observation subjects. They were divided into urinary incontinence group (n=46) and urinary control group (n=85) based on the postoperative recovery of urinary control. The two groups were compared in clinical data and perioperative indicators. Multiple logistic regression analysis was used to analyze the factors affecting the patients′ postoperative recovery of urinary control after radical prostatectomy. SPSS 20.0 was used for data analysis. Data comparison between two groups was performed usingχ² test. Results The proportion of patients aged≥75 years, body mass index (BMI)≥24 kg/m², previous transurethral resection of prostate (TURP), history of hypertension and history of diabetes in the urinary incontinence group were significantly higher than those in the urinary control group, the differences being statistically significant (P<0.05). The proportion of preoperative prostate volume of 30-75 ml, tumor stage≥T3a, and intraoperative bleeding≥600 ml in the urinary incontinence group were significantly higher than those in the urinary control group, but the proportion of the maximum urethral length preservation (MULP), preserved neurovascular bundle (NVB), complete preservation of bladder neck, and regular anal lifting training after surgery were significantly lower than those in the urinary control group, the differences being statistically significant (P<0.05). Age≥75 years, previous TURP history, tumor stage≥T3a, and intraoperative bleeding volume≥600 ml were all risk factors for urinary incontinence after radical prostatectomy (OR=2.451,3.015,2.156,3.074; P<0.05); MULP, preserved NVB, complete preservation of bladder neck, and regular anal lifting training after surgery were protective factors for urinary incontinence after radical prostatectomy (OR=0.674,0.845,0.874,0.912; P<0.05). Conclusion Various factors affect the recovery of urinary incontinence in the patients after radical prostatectomy, among which age, previous TURP history, tumor staging, and intraoperative bleeding are all risk factors for urinary incontinence after radical prostatectomy. Early intervention in the patients with high-risk factors of postoperative urinary incontinence can help reduce the incidence of urinary incontinence.