Vaccination of the elderly is an important factor in limiting the impact of influenza in the com- munity. The aim of this study was to investigate the factors associated with influenza vacci- nation coverage in hospitalized patients aged 65 years hospitalized due to causes unrelated to influenza in Spain. We carried out a cross-sectional study. Bivariate analysis was performed comparing vaccinated and unvaccinated patients, taking in to account sociodemographic variables and medical risk conditions. Multivariate analysis was per- formed using multilevel regression models. We included 1038 patients: 602 (58%) had received the influenza vaccine in the 2013 - 14 season. Three or more general practitioner visits (OR = 1.61; 95% CI 1.19 - 2.18); influenza vaccination in any of the 3 previous seasons (OR = 13.57; 95% CI 9.45 - 19.48); and 23-valent pneumococcal polysaccharide vaccination (OR = 1.97; 95% CI 1.38 - 2.80) were associated with receiving the influenza vaccine. Vacci- nation coverage of hospitalized elderly people is low in Spain and some predisposing char- acteristics influence vaccination coverage. Healthcare workers should take these characteristics into account and be encouraged to proactively propose influenza vaccina- tion to all patients aged 65 years.