Objective: To investigate the epidemiological characteristics of newly reported HIV/AIDS cases at ages of 50 years and older in Zhengzhou City from 2017 to 2021, so as to provide the evidence for formulating the AIDS control measures among the elderly. Methods: Epidemiological data of newly reported HIV/AIDS cases at ages of 50 years and older in Zhengzhou City from 2017 to 2021 were collected through the Zhengzhou Municipal Intelligent Public Health Management System. The epidemiological characteristics including population distribution, transmission route and route of detection were analyzed using a descriptive epidemiological method. Results: A total of 533 newly reported HIV/AIDS cases at ages of 50 years and older were diagnosed in Zhengzhou City from 2017 to 2021, accounting for 25.94% of all HIV/AIDS cases. There were 400 male cases and 133 female cases, with a male-to-female ratio of 3.01∶1, 288 cases at ages of 50 to 59 years (54.03%), 467 cases with an educational level of junior high school and below (87.62%), 391 cases with household registered residence in Zhengzhou City (73.36%), and 333 farmers (62.48%). Sexual contact was the main route of transmission (524 cases, 98.31%), and HIV/AIDS cases were predominantly detected by medical institutions (305 cases, 57.22%), followed by counseling and testing (167 cases, 31.33%). The proportion of HIV/AIDS cases diagnosed by medical institutions appeared a tendency towards a decline in Zhengzhou City from 2017 to 2021 (χ2trend=10.953, P=0.001), while the proportion of HIV/AIDS cases diagnosed by counseling and testing showed a tendency towards a rise (χ2trend=5.438, P=0.020). Conclusions The newly reported HIV/AIDS cases at ages of 50 years and older were predominantly local male farmers in Zhengzhou City from 2017 to 2021, with sexual contact as the main transmission route and medical institutions as the predominant route of detection. The proportion of newly reported HIV/AIDS cases appeared a tendency towards a rise.