To analyze the signing of family doctors and health service demand of community elderly people in Nanjing and Wuxi, and to find out the existing problems and propose targeted improvement methods and ideas. Among 533 elderly people, 182 family doctors signed up, accounting for 34.1%; 299 cases were not signed, accounting for 56.1%; it is not clear whether 52 cases were signed, accounting for 9.8%. The signing of elderly family doctors was statistically significant in terms of age, income level, education level and whether or not there was a spouse (<0.05). It is necessary to rationally allocate health resources, strengthen the construction of general medical talents, strengthen family doctors' signing services and community health education publicity, improve residents' cognitive depth and participation enthusiasm, improve family doctors' signing rate, promote community health education, and improve the health level of elderly residents.