Objective To investigate the prognosis value of hepcidin in elderly patients with sepsis. Methods We performed an observational study. 77 patients with sepsis admitted to intensive care unit in Shanghai Pudong New Area Zhoupu Hospital, from March 2016 to October 2016 were collected, General information was collected after admitted to hospital. Hepcidin, interleukin-6 (IL-6), procalcitonin (PCT), C-reactive protein (CRP), blood routine, sepsis related organ failure assessment (SOFA ) and acute physiology and chronic health evaluation (APACHEⅡ) score was collected within 12 hours after the diagnosis of sepsis. According to the 28 days outcome, patients was divided into death group and surviving group. Logistic analysis was used to determine the independent risk factors in prognosis of sepsis. Receiver-operating characteristic (ROC) curve was established to analyze the independent risk factors in predicting the prognosis of sepsis.  Results  ①Hepcidin, blood lactate, IL-6, SOFA score and APACHEⅡ score were significantly higher in death group than those in surviving group (P=0.01 or P＜0.01). ②Logistic analysis showed hepcidin, IL-6 and SOFA score were independent risk factors for the prognosis of sepsis (P=0.01 or P＜0.01), the risk raito (RR) was 13.44, and its 95%CI was 2.10～83.27. ③The area under curve (AUC), sensitivity, specificity, best cutoff value of hepcidin were 0.71, 80.00%, 55.77% and 1.20 μg/mL, respectively. ④Hepcidin and IL-6 were significantly higher in sepsis shock group than in sepsis group (P＜0.05). Conclusion Hepcidin is strongly associated with the severity and outcome in patients with sepsis; hepcidin is the independent risk factors of death in sepsis patients.