Objective To systematically review injury, death, and their causes in elderly people in China from 2000 to 2020 and to prevent and reduce the occurrence of injuries and death. Methods The CNKI, VIP, WanFang Data, PubMed, SinoMed, and Web of Science databases were searched to collect studies on injury and death among elderly people over 60 years of age who resided in China from January 2000 to December 2020. Two reviewers independently screened the literature, extracted data, and assessed the risk of bias of the included studies. A meta-analysis was then performed using R 4.1.2 software. Results A total of 41 studies with 187 488 subjects were included, including 125 million elderly individuals. The pooled injury mortality rate was 135.58/105 (95%CI 113.36/105 to 162.14/105, P<0.001). Subgroup analysis showed that male injury death (146.00/105, 95%CI 116.00 to 183.74, P=0.001) was significantly higher than that of females (127.90/105, 95%CI 102.31 to 159.88, P=0.001) and that overall injury mortality increased exponentially with age (R2=0.957), especially in those over 80 years old. The spatial distribution showed that the injury death rate in the central region was higher than that in the east and west and higher in the countryside than in the city. The time of death distribution showed that after China became an aging society (2000-2020), the time of death was significantly later than before (1990-2000). There were more than 12 types of injuries that caused death, the top three of which were falling, traffic accidents, and suicide. Conclusion From 2000 to 2020, the injury mortality rate of the elderly people in China initially increase and then slightly decrease. The phenomenon affects more men than women, especially those beyond the age of 80. Regional differences are identified, and the types of injuries that cause death are mainly falls, traffic accidents, and suicide. Due to the limited quantity and quality of the included studies, more high-quality studies are needed to verify the above conclusion.