Objective To analyze the efficacy and safety of low dose colchicine combined with allopurinol in the treatment of gout in the elderly.Methods 68 elderly gout patients admitted to West China Hospital of Sichuan University from December 2019 to December 2020 were divided into the control group and the observation group by random number table method. Both groups were treated with conventional symptomatic treatment. The control group (n=34) used allopurinol on the basis of conventional symptomatic treatment, and the observation group (n=34) used small dose colchicine on the basis of the control group to compare the efficacy, pain, blood routine indicators, inflammatory factors Incidence of adverse reactions. Results The total effective rate of the observation group was higher than that of the control group (P<0.05). The number of joint pain attacks in the observation group was less than that in the control group, and the NRS score after treatment was lower (P<0.05). After treatment, uric acid and erythrocyte sedimentation rate in the observation group were lower than those in the control group (P<0.05), there was no significant difference in creatinine level between the two groups after treatment (P>0.05). After treatment, Tumor necrosis factor（TNF-α）、Interleukin-1β（IL-1β）、Interleukin-17 (IL-17) in observation group was lower than that in the control group (P<0.05). The total incidence of adverse reactions such as nausea and vomiting, upper abdominal discomfort, liver and kidney abnormalities in the observation group was lower than that in the control group (P<0.05). Conclusion The treatment of low dose colchicine combined with allopurinol in elderly gout patients can effectively control symptoms, relieve pain, reduce the number of pain attacks, improve vascular endothelial function, inhibit the expression of inflammatory factors, and is safe and reliable.