OBJECTIVES: Low vision and blindness are highly prevalent in the elder population and cause considerable economic and humanistic burden. However, there are no data on the comprehensive burden of visual impaired patients in China. This study aims to investigate economic burden of the elderly people in China with low vision and blindness. METHODS:  An on-site patient survey was conducted in Third Hospital of Peking University and Beijing Hospital from March to May 2016 in Beijing. Patients aged above 50 with corrected visual acuity less than 0.3 (the better eye) and visual impairment longer than 3 months were enrolled. The socio-demographic information, medical history, direct and indirect economic burden and quality of life (time-trade off method) were collected and evaluated. RESULTS:  A total of 207 patients met study inclusion criteria with a mean age of 68.7 years. Cataract (37%) and AMD (21%), followed by glaucoma (11%) were the major causes of visual impairment. The mean economic burden per patient was ¥60,566 ($9218), with direct medical, direct non-medical and indirect costs of 53.2%, 6.4% and 40.4% respectively. Despite the high medical cost, the actual reimbursement ratio is very low, especially for patients with AMD (4.6% for outpatient, 2.7% for inpatient). 51.7% families experienced catastrophic expenditure. The lifetime indirect burden per patient is estimated to be from ¥183,904.2 ($27,990) to ¥324,523.8 ($49,392), mainly due to home care costs and the additional cost occurred due to loss of ability for raising grandchildren. CONCLUSIONS:  The economic and humanistic burden of low vision and blindness in elder Chinese patients is substantial. With the growing aging population, it is imperative to make comprehensive interventions into on disease prevention and ensure patients’ timely and sufficient access to blindness-preventing treatments in order to alleviate visual impairment-related burden in China.