Objective To explore the application effect of medication guidance based on mobile medical APP in the safe medication of elderly patients with chronic diseases. Methods A total of 120 elderly patients with chronic diseases who were treated in Kangmei Hospital from September 2020 to March 2021 were selected as the research objects, they were divided into control group (60 cases) and observation group (60 cases) according to the random number table method.The control group received conventional medication guidance, and the observation group received medication guidance based on mobile medical APP on the basis of the control group.The medication safety behavior, medication compliance and nursing satisfaction of the two groups before and after intervention were compared. Results There were no significant differences in medication safety behavior scores, the proportion of good and poor medication compliance,medication compliance and nursing satisfaction scores between the two groups before intervention (P ＞0.05).After intervention, medication safety behavior scores, the proportion of good medication compliance and nursing satisfaction scores of the observation group were higher than those of the control group, the differences were statistically significant(P ＜0.05). Conclusion Medication guidance based on mobile medical APP can improve medication safety behavior,medication compliance and nursing satisfaction of elderly patients with chronic diseases.