Abstract: Due to the ease of measurement, pulse wave has been widely used as a substitute of electrocardiogram to calculate heart rate and heart rate variability in the wearable medical field. However, its accuracy is controversial. To explore the impact of age on the accuracy of heart rate and heart rate variability estimation using pulse wave, 100 healthy people with a wide age distribution at 20～71 were recruited. The resting pulse wave and electrocardiogram were collected synchronously, the instantaneous heart rate and heart rate variability were calculated using the time interval sequence of adjacent peak points of the pulse wave, and were compared with those calculated from the adjacent R wave peak points of the electrocardiogram (gold standard), the error in estimating heart rate and heart rate variability using pulse wave was calculated. Results showed that the estimation error of heart rate was smaller in young people under 40 ages (with standard deviation of about 0.3 bpm), and slightly larger in middle-aged and elderly people over 40 years old (with standard deviation of about 0.7 bpm). The time domain heart rate variability parameters showed a similar pattern. This study suggests that the use of pulse wave peaks to calculate heart rate/heart rate variability in elderly people should be treated with caution even under resting conditions.