Purpose: To determine the prevalence of myelinated retinal nerve fibres in the elderly Chinese population. Methods: The Beijing Eye Study, a population-based, cross-sectional cohort study, included 4439 subjects out of the 5324 invited to participate (response rate 83.4%) with an age of > 40 years. The present investigation consisted of 8663 eyes of 4378 (98.6%) subjects for whom readable fundus photographs were available. Results: Myelinated retinal nerve fibres were detected in 35 eyes (29 subjects) with a prevalence rate of 0.4 +/- 6.3%[95% confidence interval (CI): 0.27, 0.54] per eye and 0.7 +/- 8.1% (95% CI: 0.42, 0.90) per subject. The myelinated nerve fibres were located most often in the temporal inferior region, followed by the temporal superior region and the nasal region. Prevalence of myelinated nerve fibres was not associated statistically with age, gender, refractive error, visual acuity (VA), intraocular pressure, cataract, glaucoma and age-related macular degeneration. Conclusions: Myelinated retinal nerve fibres are present in about seven out of 1000 elderly Chinese in northern China, without association to VA, refractive error, glaucoma and macular degeneration.