Objective To investigate the predictive value of central venous oxygen saturation (ScvO₂) in elderly patients with acute kidney injury (AKI) after robot-assisted partial nephrectomy (RAPN). Methods Seventy-eight elderly patients who underwent RAPN in the Department of Urology, the Third Medical Center of Chinese PLA General Hospital from February to September 2022 were selected. AKI was diagnosed according to the International Nephropathy Improving Global Prognosis Criteria, and the patients were divided into AKI group (n=22) and non-AKI group (n=56) according to whether AKI occurred after surgery. Blood gas analysis of venous blood was taken after central venous puncture (T₀), 5 min after renal artery occlusion (T₁), 5 min after renal artery opening (T₂), and after surgery (T₃). Hemoglobin (Hb), arterial blood lactic acid (Lac), arterial oxygen partial pressure (PaO₂), ScvO₂ were recorded respectively. Oxygen uptake rate (O₂ER) were calculated. Multivariate logistic regression analysis was used to analyze the risk factors for postoperative AKI. Receiver operating characteristic (ROC) curve was used to analyze the predictive value of ScvO₂ for AKI in elderly patients after RAPN. Results Compared with non-AKI group, fasting plasma glucose (FPG) level in AKI group significantly increased at T₁-T₂ (P<0.05). Compared with T₀, FPG level in two groups obviously increased at T₁-T₃ (P<0.01). Compared with T₁, the FPG level in T₃ significantly increased in non-AKI group (P<0.01). Compared with non-AKI group, ScvO₂ in AKI group significantly increased at T₁-T₂ (P<0.01), Lac level at T₂ significantly increased (P<0.05). There was no significant difference in O₂ER between the two groups at each time point (P>0.05). Compared with T₀, O₂ER in T₁-T₃ significantly decreased (P<0.01), and ScvO₂ in both groups significantly increased (P<0.01). Compared with T₁, ScvO₂ in non-AKI group significantly increased at T₂-T₃ (P<0.05 or P<0.01). Compared with T₂, ScvO₂ in non-AKI group significantly increased in T₃ (P<0.05). Multiple-factor analysis showed that T₁ ScvO₂ (OR=1.127, 95%CI 1.006-1.263, P=0.039) was an independent risk factor for AKI after RAPN. ROC curve analysis showed that T₁ ScvO₂ had a sensitivity of 77.3%, specificity of 71.4%, truncation value of 81%, and area under the curve (AUC) of 0.761 in predicting AKI after RAPN. Conclusion ScvO₂ has certain predictive value for the occurrence of short-term AKI after RAPN.