To analyze the epidemiological characteristics and temporal trends in Lower Respiratory Infections（LRIs）mortality among population aged ≥60 years in China from 2010 to 2021, providing evidence for formulating and optimizing prevention and control strategies to reduce LRIs-related deaths.

LRIs mortality data for population ≥60 years were collected from the National Disease Surveillance System Cause of Death Surveillance Dataset（2010-2012）and the Chinese Cause of Death Surveillance Dataset（2013-2021）by sex, urban-rural residence, region, and age group. Mortality rates were standardized using the 2010 National Population Census data. Crude and age-standardized mortality rates were calculated to describe the mortality status of LRIs. Joinpoint 5.4.0.0 software was used to calculate the annual percent change（APC）and average annual percent change（AAPC）to analyze the temporal trends, and the chi-squared test was applied to compare mortality rates across groups.

From 2010 to 2021, a total of 255 385 LRIs deaths occurred among the monitored population aged ≥60 years in China, accounting for 87.65% of all LRIs deaths. The overall crude mortality rate was 57.45 per 100 000 population, with males（63.07/100 000）having a significantly higher mortality rate than females（52.15/100 000）, urban areas（77.95/100 000）higher than rural areas（47.04/100 000）, and the western region（66.10/100 000）higher than the eastern（59.83/100 000）and central（48.17/100 000）regions（all P<0.001）. The age-standardized mortality rate for LRIs among population aged ≥60 years showed an overall downward trend from 2010 to 2020（AAPC=-8.25%, P<0.001）. Similar trends were observed in males（AAPC=-7.77%, P<0.001）, females（AAPC=-9.04%, P<0.001）, urban areas（AAPC=-8.02%, P<0.001）, the eastern region（AAPC =-7.79%, P<0.001）, and the central region（AAPC=-8.58%, P<0.001）, while rural（AAPC=-8.04%, P<0.001）and western regions（AAPC=-8.09%, P<0.001）exhibited steady declines. Among the population aged ≥60 years, LRIs mortality increased significantly with age, while the magnitude of decline showed an upward trend. The AAPCs for the age groups 65-69, 70-74, 75-79, 80-84, and ≥85 years were -3.16%, -5.76%, -6.60%, -8.33%, and -9.90%, respectively（all P<0.05）.

From 2010 to 2021, the mortality rate of LRIs among population aged ≥60 years in China showed a downward trend, which increased significantly with age and showed marked disparities by sex, age, urban/rural residence, and geographic region.The elderly males in urban and western regions are high-risk groups for LRIs-related deaths and require focused attention and targeted control measures.