Objective To analyze the clinical characteristics, laboratory test, imaging examination, and treatment outcome of invasive Klebsiella pneumoniae liver abscess syndrome (IKPLAS) in the elderly, and improve clinicians’ understanding on this disease. Methods Clinical data of 7 elderly patients who were diagnosed with IKPLAS in a hospital from January 2020 to February 2024 were analyzed retrospectively. Results Among the 7 elderly patients with IKPLAS, there were 3 males and 4 females, ranging in age from 60 to 78 years old. All 7 patients were with community-acquired infection. The main clinical symptoms were fever (n=7), chills (n=6), upper abdominal pain (n=4), fatigue and poor appetite (n=3), cough and expectoration (n=5), vomiting (n=3), vision decrease (n=2), and disturbance of consciousness (n=1). All 7 patients had pathogenic evidence of Klebsiella pneumoniae (KP), including 4 cases with KP isolated from liver puncture pus, 3 from blood culture, and 1 from both liver puncture pus and intraocular pus. Among the 7 patients, there were 5, 2, 1, 3,1,1 cases combined with pulmonary abscess, endophthalmitis, brain abscess, bloodstream infection, urinary system infection, and pelvic infection, respectively. Conclusion Elderly patients with IKPLAS have a variety of underlying diseases and diverse clinical symptoms, showing no specificity. Once IKPLAS was suspected, timely testing for pathogen and screening for other metastatic infection sites outside the liver should be performed. Timely drainage of liver abscess and selection of appropriate antimicrobial agents for treatment based on antimicrobial susceptibility testing result can improve patients’ survival rate.