Objective: To study the prognostic factors of cerebral contusion and laceration in the elderly (age ≥60 years) after surgical treatment, to provide guidance for early clinical intervention and improve patients’ quality of life. Methods: Patients with cerebral contusion and laceration of Xuzhou Medical College Affiliated Hospital between January 2015 and December 2018 were systematically collected. All patients are completed surgical treatment within 3 days of hospitalization. Analyze the clinical data (including gender, age, preoperative pupil change, coagulation function, preoperative Glasgow Coma Scale (GCS) score, first Rotterdam CT, with or without hypertension, diabetes). The Glasgow Outcome Scale (GOSE) score (1–4 poor prognosis, 5–8 good prognosis) at least 6 months after surgery was used as the prognostic index for statistical analysis to obtain factors related to patients prognosis. Results: Among the 93 patients, 33 had a good prognosis, with a good prognosis rate of 35.48%. Univariate analysis showed that age, preoperative GCS score, first Rotterdam CT score, coagulation function and pupil changes were related to the prognosis of the patients, while gender, presence or absence of hypertension and diabetes were not significantly related to the prognosis of the patients. Multivariate analysis showed that coagulation function and first Rotterdam CT were independent risk factors affecting the prognosis of patients. Conclusion: Coagulation function and first Rotterdam CT score are independent risk factors of affecting the prognosis of patients. The first Rotterdam CT score can not only determine the severity of the patient’s condition but also preliminarily determine the prognosis and recovery of the patient.