Objective To compare the therapeutic effects of His beamPurkinje system pacing and right ventricular inflow tract septum pacing on the elderly and provide a basis for patient treatment options. Methods From January 2018 to December 2019, 70 patients with cardiac pacemaker implantation were randomly divided into His beamPurkinje system pacing group and the right ventricular septal pacing group, 35 cases in each group. They were treated with his bundle Purkinje system pacing and right ventricular inflow septum (RVIS) pacemaker implantation respectively. The basic electrical parameters and shortterm follow-up results of the two groups were compared and analyzed. Results There was no significant difference in the threshold of bipolar pacing, R wave perception, impedance, QRS duration and QTc duration between the two groups (all P > 0.05). There was no significant difference in QRS duration, QTc duration, LVEF, LVEDd and mitral regurgitation area between the two groups (all P > 0.05). Conclusion There is no significant differencebetween the pacing of the His beamPurkinje system and the pacing of the right ventricular inflow tract septum. If the difficulty of the operation is considered, the right ventricular inflow septal pacing technology can be selected as a priority.