Abstract: Objective To understand the risk factors of HIV infection among the elderly in rural area in Yueqing, Zhejiang province, and provide scientific evidence for the prevention and control of AIDS. Methods Face to face interview was conducted among the>50 years old people living with HIV/AIDS (PLWHA) reported in rural area of Yueqing to collect the information about their demographic characteristics. high risk behavior and AIDS knowledge awareness. The results were analyzed. Results A total of 91 PLWHA, including 65 males and 26 females, were interviewed, their average age was 63.3 years. Up to 75.3% the married once lived apart from their spouses and 72.3% of the males had history of commercial sex, the average age to have first commercial sex was 58.1 years. Among these males, 80.9% were aged>50 years, 83.5% never used condom at commercial sex, 80.9% paid less than 50 yuan RMB for each commercial sex and 12.3% had MSM behavior. Conclusion The low grade commercial sex was the major risk factor of HIV infection in these elderly people and MSM behavior was discovered among them. It is necessary to develop the HIV prevention and control strategy targeting the elderly.