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This study aims to assess the burden of cirrhosis in older people at different socio-economic development levels globally, regionally and nationally from 1990 to 2021. Global, regional and 204 country/territory estimates of deaths and disability-adjusted life years (DALYs) due to cirrhosis among older people aged 65 years and older, with corresponding 95% uncertainty intervals, were extracted from the Global Burden of Disease Study 2021. Additionally, age-standardized prevalence rates for cirrhosis were derived for global, regional, and national levels for 2021. Joinpoint regression analysis was used to assess the trends from 1990 to 2021 by calculating the Annual Percentage Change and Average Annual Percentage Change, along with their 95% confidence intervals. From 1990 to 2021, the number of deaths due to cirrhosis increased, but the age-standardized death rate (ASDR) declined each year, with an Annual Average Percentage Change of -1.23 (95% CI, -1.3 to -1.16). The highest ASDR and age-standardized DALY rates for cirrhosis in the older adults in 2021 were mainly concentrated in the middle and low-middle socio-demographic index regions. Deaths from cirrhosis in the elderly increased with age in all senior age groups, but DALYs were slightly decreasing with age. As can be seen from the slope index of inequality, the difference in DALYs rates between the countries with the highest and lowest socio-demographic indexes is -445.18 and 76.83 per 100,000 population, respectively. In contrast, the analysis of relative inequality reveals that the health concentration index remains almost constant between 1990 (0.15) and 2021 (0.1). Globally, there has been a gradual increase in the number of deaths and DALYs due to liver cirrhosis in the older adults. It is significantly higher in males than in females. However, there has been a corresponding decline in ASDR and age-standardized DALY rates. This trend is expected to continue until 2030.