Introduction For elderly, pruritus is considered the most common complaint in outpatient clinic. Pruritus occurs in association with primary skin disorders and can also be caused by many diseases and drugs. The aim of the work was to study clinical and laboratory characteristics of elderly patients with pruritus in Sohag, Egypt. Patients and Methods A cross-sectional study was conducted on 225 patients aged ≥60 years of both sexes complaining of pruritus and 160 age- and sex-matched patient group complaining of non-pruritic dermatological diseases. CBC, ESR, renal function tests, serology for HBV and HCV and blood glucose levels were done routinely in all patients (both groups). Skin biopsy was done in some selected cases. Results The mean duration of pruritus was 4.23 ± 4.9 months and was generalized in 73.8% of cases with moderate severity in 35.1% with winter exacerbation in 20%. Dermatological causes of pruritus were detected in 54.2%, followed by systemic causes in 29.8%. Eczema was the most common skin cause of senile itching in 33.7%, while renal diseases were the most common systemic cause in 46.2%. Conclusion Senile pruritus is a common problem in elderly. Early and proper management is mandatory to improve their quality of life.