Objective To evaluate the relationship between the stroke and bleeding clinical events and age increase in elderly patients with atrial fibrillation. Methods A total of 360 elderly AF patients, mean age (84.2 ± 0.5) years, were enrolled. All patients were grouped into 70 - 79 years group, 80 - 89 years group and ≥ 90 years group based on age. The CHADS2 score, CHA2DS2 - VASC score and HAS – BLED score were analyzed. Comparison of bleeding and stroke cases in the three groups of patients was analyzed, and the follow-up study of the incidence of bleeding and stroke was analyzed. Results The prevalent of the bleeding and the stroke were both significantly increased with aging. The CHADS2 score in patients with 70 - 79, 80 - 89 and ≥ 90 years old groups increased in turn, which were 1.9 ± 0.1, 3.2 ± 0.1 and 3.9 ± 0.2, respectively(F=8.121, P=0.000); the CHA2DS2-VASC score in patients with 70 - 79, 80 - 89 and ≥ 90 years old groups increased in turn, which were 3.0 ± 0.1, 5.1 ± 0.1 and 5.7 ± 0.2, respectively(F=7.548, P=0.000); the HAS-BLED score in patients with 70 - 79, 80 - 89 and ≥ 90 years old groups increased in turn, which were 2.0 ± 0.1, 3.3 ± 0.1 and 3.7 ± 0.1, respectively (F=6.667, P=0.000); the CHADS score, CHA2DS2 - VASC score and HAS - BLED score were significantly increased with aging. Twenty-four (6.4%) patients experienced "bidirectional events" [concomitant stroke/thromboembotic event (TE) and hemorrhage], of whom 17 (73.9%) suffered recurrent TEs. Conclusions Risk of stroke and bleeding increased with age in elderly patients with atrial fibrillation; elderly AF patients prone to "bidirectional event" (thrombosis and bleeding), and the prognosis is poor.