Abstract: Objective To analyze the causes and clinical features of 246 cases elderly patients with hepatitis AE markers negative liver dysfunction.Methods To detect hepatitis A-E virus serum markers、Epstein-Barr virus antibodies、herpes simplex virus antibodies、cytomegalovirus antibodies coxsackie virus antibodies and autoantibodies.To take abdomen B ultrasound or computerized tomography (CT) examination.There were two control groups, one was 177 cases of elderly patients with hepatitis AE, and the other was 40 cases of middle-aged patients with hepatitis AE markers negative liver dysfunction.Chi-square test and t test were used to tatistical analysis.Results Among elderly patients with liver dysfunction, 58.26% were hepatitis A-E markers negative.The top four cases were :27.64% were of unknown causes, 21.54% were caused by biliary diseases, 20.33% were caused by autoimmune disorders, and 15.04% were EB virus-infected.The proportion of fatty liver (2.85%) was lower than middle-aged groups (P<0.05) .The elderly patients with hepatitis negative liver dysfunction had higher incidence of thick urine and poor appetites than that of middle-aged patients (P<0.05) .As for clinical types, 81.71% exhibited acute liver damage and the incidence of chronic liver damage, liver failure, cirrhosis was less than that of elderly patients with hepatitis AE (P<0.05) .Conclusion The incidence of hepatitis-markers-negative liver dysfunction in elderly patients were high.The clinical of manifestations and diseases severity were lighter than that of middle-aged patients and elderly patients with hepatitis.