Objective To explore the dynamic changes and influencing factors of CD4 cells in HIV-infected/AIDS patients aged≥50 years who received national free antiretroviral therapy(ART) within 60 months in Changde City. Methods HIV-infected/AIDS patients aged≥50 years who were diagnosed and registered in Changde City from January 1, 2005 to December 31, 2017 were selected, data of CD4 cell counts before therapy as well as 3, 6, 12, 24, 36, 48, and 60 months after therapy were collected, according to baseline CD4 cell count, three groups (< 200 cells/μL, 200-cells/μL and ≥350 cells/μL) were divided. Changes and influencing factors of CD4 cell counts with therapeutic time in patients aged ≥50 years with different baseline CD4 cell levels were analyzed. Results A total of 497 patients were included in study. CD4 cell counts of patients with baseline CD4 cell count < 200/μL and 200-/μL showed a continuous growth trend after therapy, while those with baseline CD4 cell count ≥ 350/μL showed a wavy growth trend. The results of growth model showed that patients with high baseline CD4 cell count had relatively high CD4 cell count after therapy, patients with homosexual transmission had higher CD4 cell count after therapy than those with heterosexual transmission and other infection transmission. Conclusion Changes of CD4 cells in HIV-infected/AIDS patients ≥50 years with baseline CD4 cell count ≥350/μL fluctuate greatly after therapy, but patients with higher baseline level have relatively higher CD4 cell count after therapy, which indicates that the baseline level of CD4 cells is always a crucial factor for the growth of CD4 cell count after ART.