Objective To investigate the attitudes to ageing in elderly stroke patients, and to analyze its influencing factors, so as to provide a reference for implementing targeted intervention. Methods A total of 423 elderly stroke patients were investigated by utilizing a general information questionnaire, the Attitudes to Ageing Questionnaire (AAQ), the Kessler Psychological Distress Scale (K10), the Lubben Social Network Scale-6 (LSNS-6), the Intergeneration Support Scale and the Sense of Nostalgia Scale. Results The participants′ AAQ score was (72.22±18.05). Multiple linear stepwise regression analysis showed that, family per capita monthly income, self-rated health status, stroke complications, hobbies, physical exercise, the K10 score, the LSNS-6 score, and the score of the Intergeneration Support Scale and the Sense of Nostalgia Scale were the influencing factors of attitudes to ageing in elderly stroke patients (all P<0.05), which explained 62.1% of the total variation. Conclusion The attitudes to ageing in elderly stroke patients is at a medium level, and medical staff should take tailored intervention according to the identified influencing factors, so as to help them foster positive attitudes towards ageing.