Background <p>To explore the potential profiling of social alienation in elderly stroke patients and to analyze their influencing factors.</p> Methods <p>A cross-sectional study was conducted. From June 2024 to March 2025, elderly patients with stroke who were hospitalized in the Department of Neurology and the Rehabilitation Department of the First Affiliated Hospital of Jinzhou Medical University were selected as the research subjects. A general information questionnaire, social support rating scale, psychological elasticity scale, self-perceived burden scale, and general alienation scale were used to investigate. Latent profile analysis was employed to explore potential subtypes of patients’ social alienation, and multivariate logistic regression was used to analyze the influencing factors of different categories.</p> Results <p>Elderly stroke patients’ social alienation was categorized into 3 subtypes: the " Low-level social alienation " (25.4%), the “moderate social alienation” (60.1%), and the " High-level social alienation” (14.5%). Patient age, education level, monthly family income, degree of self-care, number of episodes, number of comorbid chronic diseases, social support, psychological resilience, and self-perceived burden were predictors of potential social alienation typology in elderly stroke patients (<i>p</i> &lt; 0.05).</p> Conclusion <p>Heterogeneity exists in the social alienation of elderly stroke patients, and healthcare professionals should take targeted measures according to different categories of patients to improve their social alienation and promote their physical and mental health.</p>