Objective To investigate the correlations between hemorheology and blood lipids in elderly patients with sudden deafness (SD). Methods A total of 82 elderly SD patients admitted to Changsha Central Hospital from August 2020 to August 2022 were selected, including 50 males and 32 females, aged (68.73±5.17) years. Another 60 healthy individuals who came to our hospital for physical examination during the same period were selected as a control group, including 34 males and 26 females, aged (69.01±5.33) years. The hemorheology indexes and blood lipid indexes of the two groups of subjects were detected, and according to the type of hearing loss, the elderly SD patients were divided into a low-frequency decline type (18 cases), a high-frequency decline type (22 cases), a flat decline type (33 cases), and a total deafness type (9 cases). The differences of hemorheology and blood lipid levels among all groups were compared, and the correlations between impaired frequency hearing threshold and hemorheology and blood lipid levels were analyzed. χ2 test, t/F test, and Spearman correlation analysis were used for statistical analysis. Results The levels of whole blood viscosity (WBV) [(5.75±1.24) mPa·s vs. (3.50±0.87) mPa·s], red cell assembling index (RCAI) [(4.69±1.01) vs. (2.83±0.58)], fibrinogen (Fib) [(4.25±0.94) g/L vs. (2.30±0.55) g/L], total cholesterol (TC) [(5.36±1.12) mmol/L vs. (3.12±0.88) mmol/L], triglyceride (TG) [(4.25±1.08) mmol/L vs. (2.40±0.75) mmol/L], and low density lipoprotein cholesterol (LDL-C) [(3.22±1.06) mmol/L vs. (1.90±0.74) mmol/L] in the SD group were higher than those in the control group, and the level of high density lipoprotein cholesterol (HDL-C) [(0.94±0.33) mmol/L vs. (1.15±0.40) mmol/L] was lower than that in the control group (all P<0.05). The levels of WBV, RCAI, Fib, TC, TG, and LDL-C in the total deafness type group were (6.92±1.39) mPa·s, (5.45±1.26), (5.09±1.15) g/L, (7.06±1.40) mmol/L, (5.48±1.30) mmol/L, and (4.45±1.29) mmol/L, those in the flat decline type group were (5.81±1.43) mPa·s, (4.85±1.08), (4.48±1.01) g/L, (5.89±1.16) mmol/L, (4.82±1.11) mmol/L, and (3.83±1.09) mmol/L, those in the high-frequency decline type group were (5.30±1.20) mPa·s, (4.46±0.92), (3.73±0.90) g/L, (5.07±1.07) mmol/L, (4.07±0.98) mmol/L, and (3.12±0.98) mmol/L, and those in the low-frequency decline type group were (4.05±0.99) mPa·s, (3.52±0.87), (2.89±0.75) g/L, (3.12±0.88) mmol/L, (3.45±0.90) mmol/L, and (2.86±0.87) mmol/L; the levels of WBV, RCAI, Fib, TC, TG, and LDL-C in the total deafness type group were higher than those in the other three groups (all P<0.05). The HDL-C level in the total deafness type group was lower than that in the flat decline type, high-frequency decline, and low-frequency decline type groups [(0.61±0.20) mmol/L vs. (0.78±0.29) mmol/L, (0.87±0.33) mmol/L, (1.02±0.38) mmol/L], with a statistically significant difference (P<0.05). Spearman correlation analysis showed that the impaired hearing thresholds of low-frequency decline and high-frequency decline types were positively correlated with WBV (r=0.510 and 0.562, both P<0.05); the impaired hearing thresholds of low-frequency decline, high-frequency decline, flat decline, and total deafness types were negatively correlated with HDL-C (r=-0.539, -0.443, -0.495, and -0.683; all P<0.05). Conclusions Elderly SD patients have abnormal hemorheology and blood lipids. The impaired hearing threshold is positively correlated with WBV and negatively correlated with HDL-C. Monitoring the above indicators is beneficial to the diagnosis and treatment of elderly SD patients.