As the global population ages, the incidence of chronic kidney disease (CKD) in the elderly has increased year by year. Due to changes in the physical, psychological, economic, and social status of the elderly, CKD in the elderly has its own particularity. Elderly patients with CKD are prone to diabetes, hypertension, cardiovascular and cerebrovascular diseases, and other basic diseases, and the possibility of drug treatment and surgical treatment is high, which increases the chance of kidney damage. Elderly patients with CKD are also prone to decline of physical and cognitive function, depression, malnutrition, osteoporosis, and weakness, which need comprehensive evaluation. Elderly patients with CKD have a high risk of complications and death. Thus it is necessary to evaluate the patients′ conditions individually to predict the risk of death or progression to ESRD, so as to decide whether to mainly provide supportive treatment for protecting the kidney, or to provide supportive treatment together with preparing the renal replacement therapy. High-quality clinical studies in elderly CKD patients should be conducted to provide more evidence-based data for the diagnosis and treatment.