Objective To explore the effect of stress vaccine on fear of hypoglycemia in left-behind community-dwelling elderly diabetes patients. Methods A total of 126 left-behind community-dwelling elderly diabetes patients having fear of hypoglycemia were selected from 6 communities in Changchun City and were randomized into a control group and an intervention group of 63, receiving either conventional psychological care or stress vaccine training respectively. The levels of hypoglycemia fear and blood glucose before and 8 weeks after the intervention were compared between the two groups. Results The intervention group had milder fear of hypoglycemia and lower levels of fasting blood glucose, 2 h postprandial blood glucose, and glycated hemoglobin (HbA1c) compared with the control group after 8-week intervention (P＜0.01 for all). Conclusion Stress vaccine could alleviate fear of hypoglycemia in left-behind community-dwelling elderly diabetes patients and achieve better blood glucose control.