Objective: To analyze the current status and influencing factors for latent tuberculosis infection (LTBI) among the elderly in Nanchuan District, Chongqing Municipality, so as to provide a reference for developing targeted prevention and control measures and reducing the risk of tuberculosis incidence. Methods: From June to December 2024, a multi-stage random cluster sampling method combined with probability proportional to population size sampling was used to select residents aged ≥65 years from four townships (streets) in Nanchuan District as study participants. Demographic information, disease history, and history of close contact with tuberculosis were collected through a questionnaire survey. Tuberculin skin test (TST) was used to detect Mycobacterium tuberculosis infection. LTBI was defined as a mean induration diameter of ≥10 mm on the TST, with active pulmonary tuberculosis excluded. Factors affecting LTBI among the elderly were identified using a multivariable logistic regression model. Results: A total of 3 699 participants were surveyed, including 1 707 males (46.15%) and 1 992 females (53.85%). The median age was 71.00 (interquartile range, 8.00) years. There were 285 participants (7.70%) with pulmonary disease, 18 (0.49%) with immune system disease, 47 (1.27%) with a history of tuberculosis, and 17 (0.46%) with a history of close contact with tuberculosis. LTBI was detected in 628 participants, with a detection rate of 16.98%. Multivariable logistic regression analysis showed that elderly participants with senior high school education or above (OR=2.292, 95%CI: 1.508-3.484), those with immune system disease (OR=3.226, 95%CI: 1.240-8.393), and those with a history of tuberculosis (OR=4.797, 95%CI: 2.436-9.447) were significantly associated with a higher risk of LTBI. Conclusions The detection rate of LTBI among the elderly in Nanchuan District was relatively low. Educational level, immune system disease, and history of tuberculosis were influencing factors for LTBI risk in this population. It is necessary to strengthen health education, screening, and preventive interventions.