Abstract:ObjectiveTo summarizes the causes of misdiagnosis of hypothyroidism in the elderly to improve its diagnosis and treatment. Methods The clinical manifestations, diagnosis and treatment of 3 elderly patients with hypothyroidism admitted to Shaanxi Provincial Peoples Hospital from January 2020 to January 2022 were analyzed retrospectively. Results One case was misdiagnosed as a urinary system disease with multiple serous cavity effusion as the first symptom. One case presented cardiovascular symptoms and was misdiagnosed as dilated cardiomyopathy. Another case presented neuropsychiatric symptoms and was misdiagnosed as senile dementia and depression. After being confirmed as hypothyroidism with thyroid function test, all 3 cases were treated with levothyroxine tablets orally, and the clinical symptoms were effectively controlled. Conclusion As the clinical symptoms of hypothyroidism are diverse and nonspecific with occult onset, the possibility of hypothyroidism should be concerned when multiple symptoms occurred in the elderly patients.