To investigate the value of national early warning score for predicting the condition and prognosis of elderly patients in the emergency department. 1034 elderly patients admitted to our hospital from January 2019 to December 2019 were divided into general ward group and intensive care unit group according to the direction of emergency treatment; meanwhile after 1 mo, patients were divided into death and survival groups according to their actual conditions. All patients were evaluated using the modified early warning score and the national early warning score and the prognostic value of the national early warning score for elderly patients was assessed using the receiver operating characteristic curve. Comparison of gender, age, systolic blood pressure and body temperature between the general ward group and intensive care unit group, the differences were not statistically significant (p>0.05), the differences in consciousness, respiratory support, mode of admission and renal failure between the two groups were statistically significant (p<0.05). The pulse rate, respiratory rate, modified early warning score and national early warning score were significantly higher and oxygen saturation was significantly lower in the intensive care unit group than that of in the general ward group (p<0.05). In the death group and the survival group, the differences in sex, age, systolic blood pressure, pain and temperature were not statistically significant (p>0.05); the differences in consciousness, respiratory support, mode of admission and renal failure were statistically significant (p<0.05). The pulse rate, respiratory rate, modified early warning score and national early warning score were significantly higher and oxygen saturation was significantly lower in the death group than that of in the survival group (p<0.05). Frequency, modified early warning score and correction modified early warning score were all higher than those in the surviving group and oxygen saturation was lower than those in the surviving group. The results of receiver operating characteristic curve showed that the index and sensitivity of national early warning score was significantly higher than that of modified early warning score. Both modified early warning score and national early warning score can predict the condition and prognosis of elderly patients in the emergency department. The national early warning score is closer to the actual situation of elderly patients, more accurate and comprehensive than the modified early warning score score in reflecting the criticality and changes in the condition of elderly patients and has a greater ability to predict the prognosis of patientsis.