Abstract Background: Long-term outcome data from real-world studies on drug implementation CBictegravir emtricitabine tenofovir alafenamide fumarate(BIC/TAF/FTC) regimen in the treatment of elderly patients with HIV/AIDS data are still limited. This study evaluated the real-world effectiveness and safety of BIC/TAF/FTC in people living with HIV (PLHIV) in Southwestern China. Methods: This was an observational, single-center, retrospective study that enrolled antiretroviral therapy (ART)-naïve (n = 149) and ART-experienced patients with HIV (n = 143) between January 2021 and April 2024. Analysis of virological efficacy and safety, the main end point is the viral suppression rate of HIV RNA < 50 copies/ml at 48 weeks, and the change of CD4 cell count, CD4/CD8 ratio, body weight, blood lipid and safety are secondary results. Results: The proportion of treatment-naïve and ART-experienced PLHIV with a VL <50 copies/mL at 48 weeks was 90.6% and 92.9%, respectively. The CD4 count increased significantly by 102.0cells/μL(P＜0.001) and 51.0cells/μL(P＜0.001), in the ART-naïve and ART-experienced patients, respectively. During the follow-up of 149 ARTnaïve and 143ART-experienced patients using BIC/FTC/TAF, The estimated incidence of drug-related adverse events was 9.4% and 5.6%, respectively. however, these events did not lead to drug withdrawal. Conclusions: BIC/TAF/FTC can achieve better antiviral efficacy and immune recovery in newly treated and treated patients. However, in terms of safety, BIC/TAF/FTC has an impact on blood lipids in elderly patients. It is suggested that elderly patients who use this scheme should closely detect the changes of their lipid profiles. Keywords: Efficacy and safety; Bictegravir/emtricitabine/tenofovir alafenamide fumarate; Elderly patients with HIV/AIDS.