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There were 145 elderly patients with DLBCL diagnosed between 2008 and 2014. After excluding patients with primary central nervous system DLBCL (n=9) and incomplete data (n=3), a total of 133 patients (64 male and 69 female) with a median age of 74 years (range 65 to 94 years) were enrolled in the present study. Patients at a younger age and with better performance status were more likely to receive intensive frontline treatment. The median progression-free survival (PFS) and overall survival were 15 and 21 months, respectively. Anthracycline-containing chemotherapy achieved a higher remission rate and showed a trend toward better overall survival at the expense of a higher risk of severe neutropenia. Multivariate analysis revealed that very old age (≥81 years), a high-risk age-adjusted international prognostic index (aaIPI) score, and bone marrow involvement were associated with poorer PFS and overall survival. Progression of lymphoma was the major cause of death in the study population. In addition, approximately 25% of patients died within 120 days of their diagnosis. The risk factors for early mortality included very old age, a high-risk aaIPI score, and bone marrow involvement. The appearance of symptoms or signs of tumor lysis syndrome at diagnosis was associated with a trend toward early death.