We conducted a retrospective statistical analysis of 52 bullous pemphigoid (BP) patients who were over the age of 65 and treated in the South Miyagi Medical Center between January 1, 2003, and December 31, 2012, to identify risk factors affecting the prognosis in elderly patients with BP. The mean age of the patients at entry was 84.3 years (median, 84 years; range, 68-96 years). Of the 59 patients, 23 were male (44.2%). Eighteen patients (39.1%) died within the first year. The risk of death for BP patients was more than 5.8 times greater than that for the general population of 84-year-old Japanese people. Univariate analysis with log-rank tests showed that disease severity of BP measured by the number of bullae occurring per day, was associated with the risk for mortality. Finally, in the multivariate model with the Cox proportional hazards regression model, male gender (adjusted hazard ratio [HR], 5.6), a higher incidence of blister formation (adjusted HR, 11.6), and an abnormal serum creatinine level (adjusted HR, 29) were significant prognostic factors. The age of patients (adjusted HR, 3) and a serum level of anti-BP180 antibodies (adjusted HR, 2) were also suggested as prognostic factors.