Brucellosis is a zoonotic infection with an annually increasing incidence in the elderly. However, few research teams studied the brucellosis disease burden on this elderly population. This study assesses the brucellosis disease burden of elderly patients in Inner Mongolia, to explore its influencing factors, and provide a scientific basis for effectively reducing the disease burden in this demographic. This study described the disease burden of brucellosis in the elderly population in Inner Mongolia from 2016 to 2020. The incidence of brucellosis among the elderly showed an annually increasing trend, with concentrated incidences from April to July each year. The male and 60-69 age groups exhibit a high prevalence of brucellosis, while Xilingol, Ulanqab, and Hohhot exhibited high disease burdens. Meanwhile, Bayannur exhibited the fastest disease burden growth. Precipitation and the value of total pastoral production were positively correlated with the disease burden. In contrast, the sunshine duration, the number of health institutions, and GDP per capita exhibited negative correlations with the disease burden. The growing brucellosis incidence and disease burden among the elderly in Inner Mongolia is a serious issue. Relevant departments and agencies should focus on protecting the male population aged 60 to 69. Continuous attention should be directed to the western regions to prevent the emergence of new high-risk areas. Strengthening the rural healthcare system through increased medical personnel and financial investment is crucial to lowering the risk of brucellosis and alleviating its impact on the elderly population.