Objective To investigate the factors that contribute to anxiety in elderly patients following thyroid surgery,with the aim of providing a scientific foundation for clinical intervention.Methods The general conditions(gender,age,place of residence,history of smoking,history of alcohol consumption,whether they were left elderly or not,and sleep)and information on the characteristics of thyroid disease(duration,pathological nature,longest diameter of the lesion,side of onset,metastasis,and preoperative thyroid function)of 65 elderly patients who underwent thyroid sur-gery in the First Affiliated Hospital of University of Science and Technology of China from January 2021 to April 2024 were collected.The Self-assessment Scale for Anxiety was adopted to assess anxiety.The multifactorial logistic regression analysis were employed to ascertain the factors influencing postoperative anxiety in elderly patients following thyroid sur-gery.Results Among elderly patients who underwent thyroid surgery,those who exhibited anxiety symptoms were more likely to exhibit the following characteristics:empty nest elderly,sleeping for less than six hours,having metastatic le-sions,and having preoperative thyroid-stimulating hormone abnormalities.These differences were statistically significant(P<0.05).The results of the multicategorical logistic regression analysis indicated that empty nest elderly(OR=7.267,95%CI:1.340-39.413,P=0.021)and elderly who slept for less than six hours(OR=5.015,95%CI:1.339-18.776,P=0.017)were at an increased risk of developing postoperative anxiety in elderly patients who had undergone thyroid surgery.Conclusions Empty nest elderly and elderly who slept for less than six hours are at a grea-ter risk of developing anxiety after thyroid surgery.Early intervention on the factors that influence anxiety can help pre-vent post-thyroid surgery anxiety in elderly patients.