To explore the value of A-DROP for the prognosis of elderly patients with community-acquired pneumonia (CAP). Methods The clinical data of patients admitted to Department of Respiratory and Critical Care Medicine of Karamay Central Hospital from January 2019 to December 2020 were retrospectively analyzed. The clinical parameters, biochemical data, A-DROP, PSI and CURB-65 were reviewed. The patients were grouped into survival and death group according to 28-day outcomes. Use ROC curve to estimate the predictive value of A-DROP, PSI, CURB-65. Results Among 137 elderly patients, 114 survived in 28 days and 423 died, A-DROP, PSI, CURB-65 score were higher in died group than survived (P＜0.0001). The AUC for 28day mortality for A-DROP, CURB-65, PSI scoring system were 0.759, 0.732, 0.755. The sensitivity was 82.61%, and specificity was 65.79% for 28day mortality of class extremely severe according to A-DROP. Median survival time was 22.638 day (95%CI：20.096-25.180) in class extremely severe. Class extremely severe was associated with 8.56 fold (95%CI 3.3-22.21)increase in mortality over class severe, and 4.28 fold over class severe (95%CI：1.32-13.9).Conclusion A-DROP scoring system is comparable in predictive value for 28day mortality in elderly patients with pneumonia to PSI and CURB-65.