Abstract: Objective To understand the epidemiological characteristics of tuberculosis (TB) in the elderly in Zhejiang province and provide evidence for the prevention and control of TB. Methods The incidence data of TB in the elderly(60 years) of Zhejiang from 2005 to 2014 were collected and analyzed. Results In the past 10 years, the incidence rate of TB and smear positive TB was in decrease, but the patients aged 60 years accounted for a large proportion (about 25%). The incidence rate of TB in the elderly was 2.23 times higher than in other populations. The incidence rate of smear positive TB in the elderly was 2.76 times higher than in other populations. The case number in the elderly aged 60-64 years was highest (21 441 cases) and the average annual incidence was highest in the elderly aged 75-79 years. The proportion of retreated patients in age group 60 years was 1.65 times higher than that in age group 60 years. The proportion of diagnosis delay in age group 60 years was also higher than that in age group 60 years, the difference was significant(2=1930.59, P0.001). Conclusion The incidences of TB and smear positive TB in the elderly were in decrease in Zhejiang, but the proportion of elderly TB patients was still high. The elderly TB patients were important source of infection with high smear positive rate. It is important to strengthen the health education in the elderly and early detection of TB in the elderly.