To investigate whether the efficacy of cold ablation combined with traditional Chinese medicine(TCM) modality in treating elderly patients with advanced non-small cell lung cancer(NSCLC) can reach the level of conventional chemotherapy.Methods:A multicenter retrospective cohort study was performed in Beijing Hospital，the Fourth Hospital of Hebei Medical University，Beijing Hospital of Traditional Chinese Medicine，Hubei Provincial Hospital of Traditional Chinese Medicine，and four other large TCM and Western hospitals from January 1，2014 to December 31，2018.Inpatients with primary lung cancer were selected as the study subjects.According to different exposure factors，220 patients were divided into the conventional chemotherapy cohort，and 96 patients were divided into the cold ablation combined with the TCM cohort.Propensity score matching(PSM) was used to make the baseline comparable，and 87 pairs were successfully matched.Then，the survival time，life quality，solid tumor response evaluation，and safety were compared between the two cohorts.Results:Compared with the chemotherapy cohort，the cold ablation combined with the TCM cohort was better in prolonging patients' median progression free survival(PFS) time，enhancing near-term efficacy，and improving patients' life quality(P<0.05)，while it was comparable to chemotherapy in overall survival benefit(P>0.05).Conclusion:Cold ablation combined with TCM modality in treating elderly patients with advanced NSCLC is superior to conventional chemotherapy in delaying disease progression，enhancing near-term efficacy，and improving patients' life quality，and is comparable to chemotherapy in overall survival benefit.It can be used as a new treatment option for elderly patients with NSCLC.