Objective To explore the prevalence, characteristics and risk factors of skin tears in elderly patients in different medical institutions in China, so as to provide reference for effective prevention of skin tear in the elderly. Methods Fifty-two hospitals or elderly care institutions were recruited from 16 provinces, 2 autonomous regions and 2 municipalities directly under the central go-vernment in China.Then patients aged 60 years and older in these institutions were selected by cluster sampling and received head-to-toe assessment of skin integrity, and their demographic data, health status and skin tear data were also collected. Results A total of 14, 675 patients were eligible and 129 of them had skin tears, with a prevalence rate of 0.88%.The prevalence of skin tear in rehabilitation hospitals was the highest （0.97%）, followed by general hospitals （0.90%）, geriatric hospitals （0.49%） and nursing homes （0）.The main contributory factors for skin tear were found to be outcome of a fall (27.13%), blunt trauma （24.03%） and removal of adhesive dressings （17.83%）.The results of logistic regression analysis showed that skin tear history and pressure injury risk （Braden score ≤16） were risk factors for skin tears in elderly patients （OR=230.240 and 4.050）. Conclusion The common causes of skin tear in elderly patients are fall, blunt trauma and removal of adhesive dressing.Skin tear history in the last 6 months and pressure injury risk are independent risk factors.It is necessary to build a simple and practical measure with acceptable predictive validity according to the risk factors.