〔Abstract〕 Objective To analyze the influencing factors of paroxysmal atrial fibrillation (PAF) in elderly patients with hypertension. Methods A total of 94 elderly hypertension patients admitted to Luoyang Central Hospital Affiliated to Zhengzhou University from September 2019 to September 2022 were selected as research objects. The patients with PAF were evaluated and divided into concurrent group and non-concurrent group. The general data questionnaire was designed by ourselves, and the relevant data of the two groups were compared. The influencing factors of PAF in elderly hypertension patients were analyzed by logistic regression. Results Among 94 elderly patients with hypertension, 30 cases were found to be complicated by PAF, the complication rate was 31.91 %. The left atrial inner diameter (LAD), left ventricular posterior wall thickness (LVPWT), neutrophil/lymphocyte ratio (NLR), in the concurrent group were greater than those in the non-concurrent group. The level of serum hypersensitive C-reactive protein (hs-CRP) was higher than that in the non-concurrent group, and the value of low density lipoprotein cholesterol (LDL-C) was lower than that in the non-concurrent group. The differences were statistically significant (P < 0.05). There was no significant difference in other general information between the two groups (P > 0.05). Multivariate logistic regression analysis showed that abnormal increase of LAD, LVPWT and NLR, high hs-CRP level and low LDL-C were all risk factors for complicated PAF in elderly patients with hypertension. Conclusion The risk of complicated PAF in elderly patients with hypertension is higher, which may be influenced by abnormal increase of LAD, LVPWT, NLR, high hs-CRP level and low LDL-C.