OBJECTIVE: To analyze the risk and factors related to the development of skin lesions due to xerosis in hospitalized elderly people. METHODS: This was a descriptive and cross-sectional study with 455 elderly people hospitalized in Paraíba (Brazil). The Risk Assessment Scale for the Development of Lesions Associated with Xerosis Cutis in Elderly People (ERLAX-53) developed in Brazil by Cruz in 2023 was used. RESULTS: The sample consisted of 272 (59.8%) elderly people from the medical clinic and 183 (40.2%) from the ICU, most of whom were females (54.5%). There were high frequencies of the variables "immobility" (58.9%), "friction and shear" (87.7%), "presence of comorbidities" (99.3%) and "predominance of dry skin" (79.8%). The correlation was positive and moderate for "mobility", "level of consciousness", "tactile sensitivity", "temperature" and "phototype". As for the risk of lesions associated with xerosis, 337 (74.1%) were at medium risk and 101 (22.2%) at high risk. CONCLUSION: 96.3% of the elderly people with xerosis cutis who participate in the study were at medium to high risk of developing addi-tional skin lesions, which is why nursing must implement preventive and treatment strategies to care for these people.