Objective This study aims to examine the potential of blood uric acid concentration as a prognostic indicator for elderly patients with gastric cancer. Method 100 cases of elderly patients with gastric cancer were selected from February 2017 to February 2022 in our hospital. The patients were divided into two groups based on their prognosis a good group 60 cases and a poor group 40 cases . All the patients' case data were collected and analyzed retrospectively. The two groups were compared in terms of their general data including age gender body mass index disease duration family history of tumor smoking history low-density lipoprotein LDL high-density lipoprotein HDL carcinoembryonic antigen CEA carbohydrate antigen 19- 9 CA19- 9 blood uric acid concentration tumor diameter tumor stage history of radiotherapy and history of surgical treatment. The impact of various factors on the prognosis of elderly patients with gastric cancer was evaluated. The patients were classified into two groups based on their blood uric acid levels with the low uric acid group comprising those with lower levels and the high uric acid group comprising those with higher levels. The survival rates of patients with different uric acid levels were then compared using Kaplan - Meier survival analysis. Additionally logistic regression analysis Spearman analysis and ROC curve analysis were conducted. Result There were no significant differences between the two groups in age gender body mass index disease duration family history of cancer smoking history LDL HDL tumor diameter tumor stage history of radiotherapy or chemotherapy or history of surgical treatment P > 0. 05 . However statistically significant differences were observed in CEA CA19 - 9 and serum uric acid levels P < 0. 05 . Kaplan-Meier survival analysis revealed a higher mortality rate in elderly gastric cancer patients with elevated serum uric acid levels with statistically significant differences in survival outcomes compared to the low uric acid group P< 0. 05 . Multivariate logistic regression analysis indicated that serum uric acid levels >420 μmol / L constituted an independent risk factor for prognosis in elderly gastric cancer patients OR = 2. 177 P<0. 05 . Spearman's analysis demonstrated a moderate linear correlation between serum uric acid levels and prognosis in elderly gastric cancer patients r = 0. 612 P < 0. 05 . ROC curve analysis demonstrated that serum uric acid levels possess certain predictive value for prognosis in elderly gastric cancer patients AUC = 0. 877 sensitivity = 86. 76% specificity = 75. 23% P < 0. 05 . Conclusion Serum uric acid levels are closely associated with the prognosis of elderly gastric cancer patients with a uniform cutoff value of 420 μmol / L. Elevated levels may indicate a poor prognosis for elderly gastric cancer patients and clinically more comprehensive treatment plans can be developed for elderly gastric cancer patients with elevated serum uric acid levels.