Objective To investigate the epidemiological characteristics of elderly viral pneumonia in Inner Mongolia Autonomous Region from 2018 to 2019 and analyze the pathogenic distribution, and to provide reference for the prevention and treatment of elderly viral pneumonia. Methods A total of 797 elderly patients with viral pneumonia admitted to our hospital from January 2018 to December 2019 were enrolled as the research subjects. All patients were tested for respiratory viral pathogens. According to the test results, the patients were divided into two groups, positive group (n=345) and negative group (n=452). The pathogenic characteristics of patients in the positive group were analyzed. The combined basic diseases, clinical characteristics, laboratory indicators, and distribution of viral pneumonia in different seasons were compared between the two groups. Results Among the 345 patients in the positive group, 319 (92.46%) were infected with single virus, mainly influenza virus (n=221, 64.06%), followed by parainfluenza virus (n=42, 12.17%). There were 26 cases infected with two or more viruses, accounting for 7.54%, mainly influenza virus + parainfluenza virus (n=15, 4.35%). The proportion of patients complicated with diabetes, cardiovascular and cerebrovascular diseases, and malignant tumors in the positive group was significantly higher than that in the negative group (P<0.05). The clinical characteristics of both groups were mainly fever and cough, with no significant difference (P>0.05). The Lym value of the positive group was higher than that of the negative group (P<0.05), while CRP and PCT values were significantly lower than those of the negative group (P<0.05). The incidence rate in the positive group was significantly higher than that in the negative group in winter (P<0.01), and it was significantly lower than that in the negative group in spring (P<0.01). Conclusion In Inner Mongolia Autonomous Region, elderly patients with viral pneumonia are complicated with many basic diseases, but the clinical symptoms are not typical, with high incidence in winter. The infection is mainly caused by influenza virus and parainfluenza virus. Laboratory indicators such as Lym, CRP and PCT can be used to identify viral pneumonia.