Objective To investigate the current status of grip strength level in elderly patients with mechanical ventilation in ICU,and to explore its influencing factors. Methods The convenient sampling method was adopted to select 218 elderly mechanical ventilation patients in ICU of a tertiary hospital in Zhejiang Province as the research subjects from January 2020 to December,and researchers completed the cross-sectional study by using a general information questionnaire,an electronic grip strength device,and the Nutrition Risk Scaling 2002. Multivariate linear regression was used to analyse the factors influencing the grip strength level of elderly patients with mechanical ventilation. Results The average grip strength level of elderly patients with mechanical ventilation in ICU was（13.8±4.7） kg. Multivariate linear regression analysis showed that gender,age,exercise mode,time of sedative drugs,and score of Nutrition Risk Scaling 2002 were the main factors influencing their grip strength level（P<0.05）. Conclusion Grip strength levels were relatively low in elderly patients with mechanical ventilation in ICU. Grip strength levels were lower in patients with mechanical ventilation who were female,elderly,previously unexercised,the time of using sedation medication for >5 d,and the score of Nutrition Risk Scaling 2002≥3. Nursing staff should strengthen the dynamic evaluation of grip strength in patients with mechanical ventilation and control the related influencing factors.