【Objective】 To identify antibody specificity in an elderly patient with hydronephrosis accompanied by ureteral stones and shock who had multiple antibodies. 【Methods】 Microcolumn gel method was used to screen unexpected antibodies of red blood cells and identify antibodies. Enzyme method and antibody absorption method were used to help judge the specificity of antibodies in patients.The ABO blood type, Rh blood type and MNS blood type of patient were determined by saline tube method. 【Results】 The patient′s blood types were O, CCDee, NNss, and a combination of anti-E, anti-c, anti-M and anti-S antibodies was detected. 【Conclusion】 Repeated blood transfusion may lead to the presence of one or more unexpected antibodies in patients. Patients with multiple or high-frequency antibodies may experience difficulties in identification and delayed blood use.