Background Intra-aortic balloon counterpulsation (IABP) is a mechanical cardiac-assist device that is used for cardiac support.There are no published reports about the use of IABP in eldedy Chinese patients,especially for those over 80 years old.The aim of this study was to describe the clinical outcomes,influencing factors,and complications in patients ≥80 years old and requiring IABP.Methods We performed a retrospective study of 134 consecutive patients who received IABP therapy.Based on age,we defined two groups; those ≥80 years old and those ＜80 years old.Results The overall mortality was 41.8％.Patients ≥80 years old had higher mortality rates than those ＜80 years old (47.9％ vs.30.2％).Patients ≥80 years old had fewer successful revascularizations (45.8％) and more pulmonary infections(47.9％) than patients ＜80 years old (60.3％ and 30.2％,respectively); these differences were statistically significant.The most common non-cardiac complication was pulmonary infection.Cardiogenic shock and pulmonary infection were risk factors for all-cause,in-hospital mortality,whereas revascularization success was a negative risk factor for the ≥80 years old patients.Conclusions IABP may be successfully and safely employed in patients ≥80 years old,having severe heart disease,with few complications.Patients ≥80 years old who need IABP therapy are less likely to have a successful revascularization and are more likely to develop pulmonary infections than patients ＜80 years old.