Abstract: Objective To explore the prognostic value of hemoglobin levels in the elderly lung cancer patients after treatment with chemotherapy. Methods We conducted retrospective cohort study of 73 elderly patients with non-small cell lung cancer (NSCLC). The hemoglobin (HGB) was measured before the start of chemotherapy. Patients with HGB level ≤110 g/L were assigned as the anemia group and others were the normal group. The efficacy and long-term survival were retrieved. Results Those with normal (normal group) or low HGB (anemia group) had similar demographic features(P>0.05). Overall survival of normal group was longer than that of anemia group, and the difference showed a tendency toward statistical significance (P=0.137). Multivariate analysis demonstrated a survival advantage for normal group (P=0.045,HR=0.544,95%CI=0.300-0.985). Conclusion HGB levels have a potential prognostic value for the chemotherapy treatment on elderly advanced NSCLC patients.