Background and objective Erlotnib is the inhibitor of epidemic growth factor receptor and mainly used to treat non-small cell lung cancer (NSCLC). The aim of this study is to evaluate the antitumor efficacy and toxicity of erlotnib in the treatment of Chinese elderly NSCLC patients with multimetastases. Methods Tirty-three Chinese elderly NSCLC patients with multimetastases received 150 mg of erlotnib orally once daily until disease progressing or intolerable toxic developing. Results Tirty patients were evaluable for therpeutic effect. Without complete regression being observed, 6 patients got partial resonse (PR, 20%), 16 stable disease (SD, 53.33%) and 8 progressive disease (PD, 26.68%). The total response rate was 20.0% and disease control rate including both tumor response and stable disease was 73.3%. On the pathology, compared with the patients with squamous cell carcinoma, those with adenocarcinoma had not significant longer median overall (13.592±1.914 months vs 9.846±1.598 months, P=0.301) and progression-free survival times (7.367±0.923 months vs 6.615±1.366 months, P=0.488), The median survival was sigificantly related with meningeal metastasis, metastasis of liver, pleural efusion using survival analysis. The main toxicities of erlotnib were skin toxicity (rash) and diarrhea with no need of further treatment. Conclusion Erlotnib demonstrates significant antitumor activity and a favorable tolerability profile in Chinese elderly advanced NSCLC patients with multimetastases.