Background: Recently, the prevalence of atopic dermatitis (AD) in the elderly has increased and has been reported to be as high as 4%, emphasizing its clinical significance. Treating pruritus in elderly patients can be challenging due to the high prevalence of comorbidities and adverse events associated with conventional systemic medications.Dupilumab has demonstrated favorable safety and effectiveness across all age groups, making it a promising treatment option for the elderly population. Objective: To evaluate the efficacy and safety of dupilumab in elderly patients with AD or other pruritic conditions. Methods: A multicenter, retrospective, real-world study on the efficacy and safety of dupilumab was conducted in patients aged 65 years or older. Patients with AD and other pruritic conditions were assessed separately for dupilumab efficacy using objective and subjective scores. The patients who received regular injections were evaluated at 16 and 40 weeks after treatment. Results: Forty-seven patients participated in the study, of whom 37 were diagnosed with AD and 10 were classified as having other pruritic conditions. In patients with AD, there was a 78.6% reduction in the mean Eczema Area and Severity Index score at week 16 compared with baseline. All patients with other pruritic conditions demonstrated a decrease in the Investigator’s Global Assessment score of at least 2 points or a Numerical Rating Score reduction of at least 4 points. Adverse events occurred in five patients, but no serious adverse reactions were observed. Conclusion Dupilumab can be considered a safe and effective treatment for elderly patients with AD and other pruritic conditions.