AIM: To analyze the relation of hypoglycemic coma and xiaoke pills. METHODS: The relation of hypoglycemic coma and xiaoke pills were analyzed retrospectively from the five cases of old patients. RESULTS: All the five old patients with diabetes died of hypoglycemic coma on the seventh day to the thirteenth day, after taking xiaoke pills. CONCLUSION: It must be cautious for xiaoke pills to treat diabetes in elderly patients.