Objective To explore the application effect of the intelligent question answering system in health education for elderly patients with urolithiasis, and to provide a reference for improving the effectiveness of health education for the elderly.Methods Patients undergoing urinary calculi surgery were selected using the convenience sampling method.According to their hospitalization time, 106 patients admitted from September 1 to 30, 2024 were assigned to the control group, and 103 patients admitted from October 1 to 31, 2024 were assigned to the observation group.The control group received routine health education, while the observation group was subjected to the health education assisted by an intelligent question and answer system on the basis of routine nur-sing care.The health education service experience and the incidence of perioperative abnormal events were compared between the two groups.Results The total score and the scores of each dimension of health education service experience (except for knowledge accuracy) of the observation group were significantly higher than those of the control group (all P＜0.05).The incidence rate of abnormal events in the observation group was relatively lower than that in the control group, but only the incidence rate of medical insurance registration errors showed a statistically significant difference between the two groups (P＜0.05).Conclusion The use of the intelligent question and answer system for elderly patients with urolithiasis helps to improve the efficiency of health education and the patient′s medical experience, and reduce the occurrence of abnormal events during the perioperative period.