The normal pepsinogen ratio in the elderly is usually similar to that of other age groups, with a normal range of greater than or equal to 7.5. The pepsinogen ratio is one of the factors in determining gastric pathology, and a high or low pepsinogen ratio in the elderly can indicate a possible gastric pathology. If the pepsinogen ratio is between 3 and 7.5, it may indicate the presence of Helicobacter pylori infection, gastritis, gastric ulcers, and severe gastric perforation. If the pepsinogen ratio is lower than three, it may indicate the presence of atrophic gastritis, lack of gastric acid, which can lead to pernicious anemia, acidosis, etc., thus causing chronic gastritis, gastric dilatation and duodenitis and other diseases. When the ratio of pepsinogen is not normal in the elderly, it is necessary to go to the regular hospital in time, do relevant examinations to clarify the cause of the disease, and under the guidance of the doctor’s treatment.