BACKGROUND: Human immunodeficiency virus (HIV)/AIDS among elderly persons presents a new public health challenge in China. We aimed to explore historical trends (2004-2018) and project the future (2019-2030) burden of HIV/AIDS incidence and mortality among the elderly in China. METHODS: We utilized data from the Data Center of China Public Health Science database on HIV/AIDS incidence and mortality, employing the Bayesian age-period-cohort model to reveal the age-period-cohort effect in the HIV/AIDS burden, and projecting the incidence and mortality rates up to 2030. RESULTS: From 2004 to 2018, HIV/AIDS incidence rates increased from 0.56 to 20.78 per 100 000 for men and 0.28 to 7.84 per 100 000 for women. The mortality rates also increased in both sexes. We observed the highest age effect in incidence among men aged 70-74 years and women aged 55-59 years, with the effect estimates being 0.02 (95% confidence interval [CI], -.10 to .13) and 0.46 (95% CI, .35-.57), respectively. Similar sex disparities were observed for mortality, with the highest age effect observed in men aged 75-79 years and women aged 50-54 years. However, no significant disparities were found between men and women in the period and cohort effects. By 2030, the incidence rates were projected to be 96.25 per 100 000 in men and 44.90 per 100 000 in women, while the mortality rates were projected to be 48.27 and 13.67 per 100 000, respectively. CONCLUSIONS: HIV/AIDS incidence and mortality rates rose notably among the elderly in China and are expected to keep increasing in the coming decades. Rates were consistently higher in men than in women. Tailored interventions for older men are crucial.