Objective To study the significance of anti-cyclic citrullinated peptide (anti-CCP),anti keratin antibody (AKA) and anti-RA33 autoantibodies (RA33)in the diagnosis of elderly-onset rheumatoid arthritis (EORA) and to explore the role of the united detection of anti-CCP, AKA and RA33 in the diagnosis of EORA. Methods The above three kinds of autoantibodies were detected in 69 patients with EORA, 73 patients with polymyalgia rheumatica (PMR) and 65 patients with osteoarthritis (OA). The anti-CCP and RA33 were measured by enzyme-linked immunosorbent assay (ELISA),and AKA was measured by indirect immunofluorescence (IIF). Results In the group of patients with EORA, the sensitivity and specificity of anti-CCP were 55.1% and 94.3%, the sensitivity and specificity of AKA were 31.3% and 91.5%, and the sensitivity and specificity of RA33 were 36.2% and 95.4% respectively, which were significantly higher than those in the groups of patients with PMR and OA. United-detection of anti-CCP, AKA and RA33 reduced the sensitivity,hut increased the specificity (100%) with higher positive predictive value. Conclusions Anti-CCP,AKA and anti-RA33 can emerge in the patients with EORA and the anti-CCP displays higher sensitivity and specificity. United detection of anti-CCP, AKA and RA33 can increase the specificity and positive predictive value (100%) and has high value in the diagnosis of EORA.