Objective: To investigate the effects of nebulized α-interferon on immune function in elderly patients with respiratory tract infection. Methods: A total of 120 elderly patients with respiratory tract infection admitted to our hospital from June 2023 to June 2024 were selected and randomly divided into an observation group (n=60) and a control group (n=60) using the envelope method. The control group received conventional treatment, while the observation group received additional nebulized α-interferon therapy based on conventional treatment. After the same treatment period, changes in immune function indicators (immunoglobulins IgG, IgA, IgM) were compared between the two groups. Patients were also followed up for 3 months to observe the frequency of respiratory tract infection recurrences. Results: After treatment, IgA and IgM levels decreased significantly, while IgG levels increased significantly in both groups. The improvement in each indicator was more pronounced in the observation group than in the control group (P < 0.05). By the end of the follow-up period, all 120 patients had successfully completed the follow-up, and no patients were lost to follow-up. The frequency of respiratory tract infection recurrences was lower in the observation group than in the control group (P < 0.05). Conclusion: Nebulized α-interferon can improve immune function and reduce the frequency of recurrences in elderly patients with respiratory tract infection.