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Background Retinal vein occlusion (RVO) is the second most common retinal vascular disease, with peak incidence at 70years of age. However, the bidirectional association between the risk of comorbidities and the diagnosis of RVO in this population is uncertain. Methods A population-based cohort of 1,784,960 patients 70years of age and older retrieved from the Taiwan National Health Insurance Research Database between 2000 and 2010. Risks of comorbidities were assessed 5years before and after the diagnosis of RVO. Results In our study, 3393 subjects had central RVO (CRVO) and 6688 subjects had branch RVO (BRVO). Before the diagnosis of RVO, patients showed increased risks for the following comorbidities: hypertension (odds ratio [OR]=1.83, 95% confidence interval [CI], 1.74–1.93), dyslipidemia (OR=1.29, [1.23–1.35]), DM (OR=1.29, [1.23–1.35]), liver disease (OR=1.22, [1.16–1.29]), renal disease (OR=1.30, [1.23–1.37]), and cerebrovascular disease (OR=1.16, [1.11–1.21]). After the diagnosis of RVO, patients were at greater risk of developing DM (adjusted hazard ratio [AHR]=1.12, [1.06–1.19]), PAD (AHR=1.17, [1.08–1.27]), and MACE (AHR=1.35, [1.25–1.46]); however, the risk of all-cause mortality was unchanged. Elderly patients with CRVO had a significantly higher risk of all-cause mortality (AHR=1.09, [1.02–1.17]), whereas patients with BRVO showed no significant differences in mortality. Conclusion This study suggests bidirectional association between the risk of comorbidities and the diagnosis of RVO in an elderly population.