Pro-inflammatory responses and oxidative stress damages, and effects of the reduced anti-oxidation and anti-inflammation were involved in development and progression of coronary heart disease. We tried to identify the effects of pro-inflammatory and oxidative stress biomarkers as well as anti-oxidant and anti-inflammatory factors on multiple recurrent coronary in-stent chronic total occlusions in elderly patients after coronary stenting. We determined the expression levels of endothelial progenitor cell (EPC), stromal cell-derived factor-1α (SDF-1α), vascular endothelial growth factor (VEGF), nitric oxide (NO), toll-like receptor 2 (TLR2), toll-like receptor 3 (TLR3), toll-like receptor 4 (TLR4), and soluble ST2 (sST2) in elderly patients with multiple recurrent coronary in-stent chronic total occlusions after coronary stenting. The levels of EPC, SDF-1α, VEGF, and NO were decreased in elderly patients with multiple recurrent coronary in-stent chronic total occlusions (p < .001). The levels of TLR2, TLR3, TLR4, and sST2 were increased in elderly patients with multiple recurrent coronary in-stent chronic total occlusions (p < .001). The oxidative stress damages and pro-inflammatory responses played the crucial roles in multiple recurrent coronary in-stent chronic total occlusions of elderly patients after coronary stent placement. The levels of TLR2, TLR3, TLR4, and sST2, and the expressions of EPC, SDF-1α, VEGF, and NO could be considered as potential early predictive indicators for multiple recurrent coronary in-stent chronic total occlusions in elderly patients after coronary stent implantation.