Objective To analyze the survival and its influencing factors of elderly patients with muscle-invasive bladder cancer （MiBC） after bladder sparing surgery. Methods The clinical data of 62 elderly MiBC patients who underwent bladder sparing surgery from July 2015 to August 2019 were collected, and their one-year survival was calculated. Their baseline data were also collected including age, clinical stage, number of tumor, operation method, postoperative bladder perfusion chemotherapy, and serum chemokine ligand 5 （CXCL5） level, and the influencing factors of mortality after MiBC resection in the elderly were analyzed. Results Among the 62 elderly MiBC patients, 11 cases died one year after bladder sparing surgery, with the mortality rate of 17.74%. The results of Cox regression analysis showed that a high clinical stage （T₄） and a high level of CXCL5 were the influencing factors of mortality in elderly patients with MiBC （P<0.05）. Conclusion There is a risk of mortality in elderly MiBC patients after bladder sparing surgery, and a high clinical stage and a high level of CXCL5 are the influencing factors, which can be taken into consideration to conduct reasonable interventions to prolong the survival of patients.