Few studies focused on the prognosis of sudden sensorineural hearing loss (ISSHL) of aged people. The aim of this study is to analyze the characteristics, treatment, and prognostic factors of ISSHL in aged people. A total of 278 patients diagnosed of ISSHL in aged people from 2014 to 2019 were retrospectively analyzed. Univariates were analyzed by univariate and multivariate logistic analysis. Among the 13 univariates, the patients' age was younger in the overall recovery group ORG ( = .018), while onset days was shorter in ORG ( = .000). The percentage of DM and HTN comorbidities were higher in ORG ( = .026 and .038). Meanwhile differences were significant in audiogram configurations ( = .037), the degree of hearing loss ( = .033), and types of lipid treatment ( = .020). Then these seven independent risk factors were included in the multivariate analysis, final results indicated that hypertension ( = .028), lipid control groups ( = .009), age ( = .000), and onset days ( = .001) were related to the treatment outcome of ISSHL. The prognosis of ISSHL in aged patients was closely related to age, the onset days of treatment, and good control of complications such as hypertension and hyperlipidemia, so vascular factors were considered as the main causes of morbidity.