Objective To observe the clinical efficacy of silver ion antimicrobial dressing for elderly patients with lower extremity ulcer. Methods 52 senile venous lower extremity ulcer patients were randomly divided into control group and observation group, with 26 cases in each group. The control group was treated with traditional 5％ iodine disinfection and dressing with gauze. The observation group was treated with silver ion antibacterial dressing stuffing wound dressing after 5％ iodine disinfection. The wound area, depth, exudation, pain score and nursing satisfaction between the two groups were compared. Results The wound area and the depth of wound in the observation group decreased significantly from the first week, and the difference between the observation group and the control group was statistically significant(P＜0. 01 ). From the fourth week, the exudate volume in the observation group was significantly lower than that of the control group, and the pain scores in the observation group were significantly lower than those in the control group, and the difference was statistically significant (all P＜0. 0l). The effective rate and the cure rate was 46. 2％ and 38. 5％ in observation group, significantly higher than that of the control group(30. 5％ and 15. 4％), and the difference was statistically significant(P all ＜0. 05). The satisfaction of patients in observation group and control group was 84. 6％ and 19. 2％, respectively, with significant difference (P＜0. 05). Conclusion Silver ion antimicrobial dressing for the treatment of senile venous lower ulcer has significant anti-infective effect, with high satisfaction of patients, which is worthy of clinical promotion.