This study aimed to use meta-analytic techniques to evaluate aspirin's safety and effectiveness in treating elderly patients with sepsis. We searched PubMed, Embase, The Cochrane Library, Web of Science and Medline databases for relevant literature, screened and extracted key data and Stata 12.0 was used for comprehensive analysis. From library establishment to June 2024, relevant literature on aspirin for elderly sepsis patients was retrieved from PubMed, Web of Science, Embase, Medline and The Cochrane Library. Literature for meta-analysis was screened by inclusion and exclusion criteria and valid data was extracted. Stata 12.0 software was then used for integrated analysis. Finally, a total of 12 relevant pieces of literature were included in this study, involving 136,931 research subjects. The results of the meta-analysis showed that aspirin can reduce ICU mortality, in-hospital mortality, 30-day and 90-day mortality and the incidence of bleeding events in elderly patients with sepsis. It can also shorten the length of ICU stay but can not improve the incidence of organ failure. These suggest that aspirin has good efficacy and safety in the treatment of elderly patients with sepsis.