OBJECTIVES:  Concerning that elderly should avoid to use benzodiazepine (BZD) and non-BZD hypnotics for long-term, this study aimed to observe elderly patients’ disease statuses, efficacy outcomes, and safety concerns of using BZD/Z-drugs longitudinally. METHODS:  We enrolled elderly patients who regularly visited a 2000-bed medical center and were prescribed with listed BZD/Z-drugs for more than 1 week in study group and those who had not taken these medications in control group. Those elderly who ever had severe neuropsychiatric disorders, active cancer, received organ transplantations, or couldn't cooperate with interview were excluded. All enrolled patients were interviewed for the following measures every three month and up to one year: changes in insomnia quality, functional statuses, Mini-Mental State Examination, fall experience, depression scale, occurrence of adverse drug reactions (ADRs), Morisky Medication Adherence Scale 8-item, EuroQol EQ-5D-5L, and health utilizations. RESULTS:  Up to January 19, 2017, 239, 160, 114, 64 and 17 patients, respectively, completed the first, second, third, fourth and fifth visit assessments. 53.2% of 239 elderly patients were enrolled in the study group. Comparing to that in control group, elderly patients in study group tended to: have poor EQ-5D-5L scores, have more cognitive impairment, and have poor medication adherence in first visit. More elderly in study group ever experienced falls and 42 encountered BZD/Z-drug ADRs. Of 17 patients completed 1-year follow-up, 9 patients in the study group tended to have less diseases, visited less outpatient units, spent less outpatient expenses, had better sleep quality, but had more complex medication regiments and encountered more BZD/Z-drug ADRs across times, comparing to 8 patients in control group. CONCLUSIONS:  Those elderly patients taking BZD/Z-drugs had poor clinical and humanistic outcomes, poor medication adherence, and more complex medication regiments and encountered more BZD/Z-drugs related ADRs across time than those patients not taking these medications.