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Objective To analyze the characteristics of auditory brainstem response (ABR) in presbycusis patients el-der than 90 years. Methods Fourteen presbycusis patients elder than 90 years (presbycusis group, 91.1.4 ± 1.3 years, 26 ears) and 9 normal-hearing young adults (control group, 22.7 ± 1.2 years, 18 ears) participated in the study. Alternative click-evoked ABRs were recorded in both groups. The peak latency (PL) of peak I,Ⅲ, and V, and the inter-peak latency (IPI) of I-Ⅲ,Ⅲ-V, and I-V were compared between groups. Results In elder presbycusis patients, the occurrence rate of peak I andⅢwere both 76.9%, and that of peak V was 84.6%. In presbycusis group, the peak latencies of I, Ⅲ, V were significantly longer than that of control group (P<0.001). There was no significant difference between groups in the IPI of peak I-IⅢ (P=0.298, peakⅢ-V (P=0.254) and peak I-V (P=0.364). Conclusions Auditory brainstem responses in presbycusis pa-tients elder than 90 years showed worse wave differentiation.