Objective To explore independent prognostic factors in elderly patients with glioblastoma （GBM）， so as to provide a prognostic assessment program for this population. Methods Clinical data from 180 elderly GBM patients in the Fifth Ward， Department of Neuro-oncology， Capital Medical University，between June 2006 and June 2021 were retrospectively analyzed. Patients were divided into four groups： Group A（ patients with recurrent GBM）， Group B（ patients diagnosed with primary GBM after presenting for epilepsy）， Group C（ patients diagnosed with primary GBM after presenting for neurological disorders including hemiplegia， aphasia， and cognitive impairment）， and Group D（ patients diagnosed with primary GBM after presenting for other symptoms such as headache and/or vomiting）. General information， median survival time， and pathological diagnosis were obtained from hospitalization and follow-up records. Single-factor and multi-factor Cox regression analysis and Kaplan-Meier survival analysis were performed using SPSS 27.0 to evaluate the association of various risk factors with the prognosis of elderly GBM patients. Results The median overall survival among 180 GBM patients was 353 days， with a mean overall survival of 550 days. Univariate Cox regression analysis showed that age［ HR=1.038， 95%CI（ 1.001， 1.077）， P=0.044］， postoperative radiotherapy［ HR=0.388， 95%CI（ 0.255，0.592），P ＜ 0.001］， postoperative chemotherapy［ HR=0.530， 95%CI（ 0.347，0.810）， P=0.003］， tumor molecular pathology O6-methylguanine-DNA methyltransferase（ MGMT） promoter methylation status［ HR=0.632， 95%CI（ 0.432， 0.926）， P=0.019］， postoperative Karnofsky Performance Status（ KPS） score ［HR=0.972， 95%CI（ 0.957， 0.987）， P＜0.001］， degree of tumor resection［ HR=0.951， 95%CI（ 0.940， 0.962）， P＜0.001］ were prognostic factors for elderly patients with GBM. Subgroup analysis revealed that elderly GBM patients diagnosed due to headache， vomiting， or incidental findings exhibited longer survival times than other subgroups， with statistically significant differences（ P＜0.05）. Survival times among other subgroups showed no statistically significant differences（ all P＞0.05）. Based on the Chinese Glioma Genome Atlas（ CGGA） database， factors influencing overall survival prognosis in elderly GBM patients were analyzed， and a total of 64 patients were included， with a median overall survival of 373 days and a mean overall survival of 598 days. Univariate and multivariate Cox regression analysis revealed that postoperative radiotherapy［ HR=0.258， 95%CI（ 0.098， 0.676）， P=0.006］ and postoperative chemotherapy［ HR=0.294， 95%CI（ 0.146， 0.594），P＜0.001］ were identified as independent factors influencing overall survival in elderly GBM patients， demonstrating favorable prognostic effects. Analysis of Kaplan-Meier survival curve for postoperative radiotherapy and postoperative chemotherapy in patients enrolled in the CGGA database indicated that both postoperative radiotherapy and postoperative chemotherapy significantly prolonged overall survival. Conclusions For elderly GBM patients， undergoing maximal tumor resection while preserving neurological function， followed by postoperative chemoradiotherapy， significantly prolongs survival times. Under these conditions， younger patients demonstrate longer survival times.