Objective To investigate the current status of fist⁃clenching exercise compliance in elderly patients with indwelling peripherally inserted central venous catheter (PICC), and to analyze its influencing factors. Methods A total of 120 elderly patients with indwelling PICC were selected as the research subjects. The investigation on the research subjects was performed by employing fist⁃clenching exercise cognitive scale, fist⁃clenching compliance scale, PICC⁃related venous thrombosis cognitive scale. The influencing factors for fist⁃clenching exercise compliance in elderly patients with indwelling PICC were analyzed by using the multivariate Logistic regression model. Results The total scores of fist⁃clenching exercise cognitive scale, fist⁃clenching compliance scale, and PICC⁃related venous thrombosis cognitive scale among 120 elderly patients were 15.65±7.01, 8.79±3.00, and 46.43±19.62, respectively. The total scores of the aforementioned scales were all at the medium to low levels. The results of multivariate Logistic regression analysis revealed that length of indwelling catheter days, total score of fist⁃clenching exercise cognitive scale, and total score of PICC⁃related venous thrombosis cognitive scale were the influencing factors for fist⁃clenching exercise compliance of elderly patients with indwelling PICC (P<0.05). Conclusion Compliance of fist⁃clenching exercise is relatively low in elderly patients with indwelling PICC. Length of indwelling catheter days, cognitive states of fist⁃clenching exercise, and cognitive states of PICC⁃related venous thrombosis are the influencing factors for fist⁃clenching exercise compliance in elderly patients with indwelling PICC.