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With the acceleration of aging in our country, the issue of old-age care for the elderly has been widely concerned and valued by the society. Smart elderly care is widely used in nursing homes, but it is currently impossible to monitor the physical health status of every elderly person in real-time. To effectively solve the above problems, a ZigBee-based monitoring system for the signs of the elderly was designed. The system is divided into three main modules: data acquisition, network transmission and application analysis. In the system design, portable ECG sensors, respiratory wave sensors, body temperature sensors and heart rate sensors are used to collect the sign data of the elderly. The collected data is transmitted to the server through the ZigBee wireless sensor network, and then the data is processed by application software and algorithms. Analysis and management, thus ensuring that the physical information of the elderly in the nursing home is monitored in real time. The experimental results show that the functions of data collection, transmission, analysis and other modules of the terminal and various sensors designed by the system are realized, and the system analyzes the collected information to predict the health status of the elderly, and the prediction evaluation index RMSE is 0.0371. Real-time monitoring of the health of the elderly is realized, and the health problems of the elderly are effectively protected.