Objective To explore the potential categories of self-efficacy for appropriate medication use in elderly patients with chronic multimorbidity and its relationship with medication self-management behavior, so as to provide a basis for precise intervention. Methods A total of 371 elderly patients with chronic multimorbidity who were hospitalized in three tertiary hospitals in Henan Province were selected as subjects.The research tools included the general information questionnaire, Medication Self-Management Behavior Scale for the Elderly with Chronic Diseases and Self-efficacy for Appropriate Medication Use Scale.Latent profile analysis was conducted on self-efficacy for appropriate medication use in elderly patients, and logistic regression was used to analyze the influencing factors of each potential category of self-efficacy for appropriate medication use. Results The self-efficacy for appropriate medication use in elderly patients with chronic multimorbidity could be divided into low anti-frustration group (50.13%), low control group (28.03%) and high anti-frustration-high control group (21.84%).The lower the score of medication self-management behavior, the greater the risk of individuals being classified as low anti-frustration and low control groups （all P＜0.05）. Conclusion Self-efficacy for appropriate medication use in elderly patients with chronic multimorbidity has three potential categories that interact with medication self-management behavior.Medical staff should carry out precise interventions according to the characteristics of patients′ self-efficacy in taking medicine and enhance their self-efficacy of appropriate medication use and medication self-management ability.