Objective To explore the effect of metronidazole (Met) combined with estriol ointment on senile vaginitis (SV) and its influence on patients' quality of life. Methods 124 SV patients in our hospital were taken as the research objects, and they were randomly divided into Met group (control group, n=62) and combination group of estriol ointment (observation group, n=62). Both groups were given Met, besides the observation group was given additional estriol ointment. The remission time of symptoms (vulva pruritus, congestion of vaginal mucosa and vaginal secretions) and the differences of vaginal pH values (pH), vaginal health scores and quality of life [European quality of life five dimension(EQ-5D)] before and 5 weeks after treatment in the two groups were compared. Results The remission time of related symptoms in the observation group was shorter than that in the control group (P<0.05). 5 weeks after treatment, the vaginal pH values and EQ-5D scores in the two groups were significantly decreased (P<0.05), the vaginal health scores in the two groups were significantly increased (P<0.05), and the change ranges in the observation group were greater than those in the control group (P<0.05). Conclusion Met combined with estriol ointment which has better and faster effect on SV, can regulate the internal environment of patients and improve their quality of life, and it is also beneficial to the prognosis of patients.