Objective: To analyze the value of NT-proBNP level in predicting prognosis of elderly pneumonia patients without heart failure history. Methods: A total of 503 hospitalized elderly pneumonia patients without heart failure history admitted from June 2015 to December 2018 and had NT-proBNP level detected at emergency room were enrolled. According to the interquartile range of serum NT-proBNP, patients were divided into low level group, lower level group, higher level group, and high level group. And according to the occurrence of death in hospital, patients were divided into death group (n=125) and survival group (n=378). The receiver operating characteristic curve (ROC) was used to analyze the predictive value of NT-proBNP on prognosis of elderly pneumonia patients without heart failure history and the optimal cutoff value.And multi-factor Cox regression analysis was used to analyze the influence of NT-proBNP level on prognosis of elderly pneumonia patients without heart failure history. Results: There was a difference in mortality between different groups of NT-proBNP level, and it was the highest in high level group (49.2%) (P<0.05). Compared with survival group, the NT-proBNP, serum creatinine, C reactive protein level were significantly higher and hemoglobin, serum albumin, estimated glomerular filtration rate were significantly lower（P<0.05）in death group; the occurrence of atrial fibrillation was higher and use of RAS blockers before admission was lower (P<0.05). Area under ROC (AUC) of NT-proBNP to predict in-hospital death was 0.714(95%CI: 0.504-0.925, P<0.01). The optimal cut-off value was 1 377.8 pg/mL, with a sensitivity of 75.8% and a specificity of 76.4%. Cox regression analysis indicated that NT-proBNP level（≥1 377.8 pg/mL）, hemoglobin (<131 g/L) and serum albumin(<35 g/L) were independent risk factors for the hospitalized elderly pneumoniapatients without heart failure (P<0.05). Conclusions: Serum NT-proBNP level has a substantial value for predicting the prognosis in elderly pneumonia patients without heart failurehistory.