Abstract: Objective To analyze the trends in the burden of elderly depression in China from 1990 to 2021 and its risk factors, providing a theoretical basis for the prevention and policy-making of elderly depression in China. Methods Data on the burden of elderly depression in China from 1990 to 2021, including the number of cases, disability-adjusted life years (DALY), incidence rate, and DALY rate, were extracted from the Global Burden of Disease 2021 (GBD 2021). The Joinpoint model was used to analyze the trends through annual percentage change (APC) and average annual percentage change (AAPC). A time series model was used to predict the burden of elderly depression in the next five years. Population attributable fraction (PAF) was used to describe the burden of disease caused by risk factors for elderly depression in China in 1990 and 2021. Results From 1990 to 2021, the number of cases and the incidence rate of elderly depression in China showed an overall upward trend. Among them, the incidence in the 60-64 age group increased most significantly, the prevalence in the 95 and above age group showed a significant upward trend, and the DALY rate in the 65-69 age group showed the most pronounced increasing trend. The incidence, prevalence and DALY rate of elderly depression in females were higher than those in males. Major risk factors included childhood sexual abuse and intimate partner violence, with intimate partner violence having a particularly significant impact on females. The ARIMA model predicted that in the next five years, the incidence, prevalence and DALY rate of elderly depression in China will show a downward trend, with a larger decline in females than in males. Conclusion From 1990 to 2021, the incidence, prevalence and DALY rate of elderly depression in China showed an overall upward trend, with higher rates in females. It is crucial to focus on early prevention, particularly for elderly women, to reduce the burden of elderly depression.