Objective To explore the clinical value of color Doppler Ultrasound Semi-quantitative Score (CDUSQS) in the diagnosis of elderly patients with chronic hepatitis B (CHB) and cirrhosis (HBC). Methods 84 cases of elderly patients with CHB diagnosed in our hospital from January 2016 to January 2018 were selected as the subjects by incorporating criteria,according to the results of liver biopsy, 49 cases were divided into HBC group and 35 cases of non HBC group.Two groups of patients were examined by color Doppler ultrasonography,the CDUSQS of surface capsule of liver,echo of liver parenchyma,area of spleen,shape of liver margin,clarity of hepatic vein,intrahepatic ligament and gallbladder wall were compared between the two groups,the portal blood flow, blood flow velocity and portal vein diameter were compared between the two groups,the diagnostic value of CDUSQS for elderly HBC were also analyzed and ROC curve was drawn. Results The CDUSQS of surface capsule of liver,echo of liver parenchyma,area of spleen,shape of liver margin,clarity of hepatic vein,intrahepatic ligament and gallbladder wall in the HBC group were significantly higher than those of non HBC group (P<0.05).The portal blood flow, blood flow velocity and portal vein diameter in the HBC group were greater than non HBC group (P<0.05).The sensitivity and specificity of CDUSQS in the diagnosis of elderly HBC were higher than 91%. Conclusion The application of CDUSQS in the diagnosis of HBC in the elderly has high diagnostic value.