Hydrogen sulfide (H2S), the third gasotransmitter discovered, regulates a variety of physiological functions. Whether H2S alleviates skeletal muscle ageing by regulating autophagy has not been reported. Mice were administered 150mg/kg/day of D-galactose (D-gal), and C2C12 myotubes were cultured in 20g/L D-gal to induce ageing. Sodium hydrosulfide (NaHS) was employed as an exogenous donor in the treatment group. The intracellular concentration of H2S was quantified by the 7-azido-4-methylcoumarin fluorescence probe. The proteins involved in the ubiquitin-mediated degradation of AMPKα1 were detected by liquid chromatography tandem mass spectrometry (LC-MS/MS) and co-immunoprecipitation (Co-IP). S-sulfhydration of USP5 was tested by a biotin-switch assay. Associated proteins were analysed by western blot. NaHS was found to effectively restore the H2S content in both ageing gastrocnemius (+91.89%, P<0.001) and C2C12 myotubes (+27.55%, P<0.001). In comparison to theD-gal group, NaHS was observed to increase the mean cross-sectional area of muscle fibres (+44.91%, P<0.001), to decrease the collagen volume fraction of gastrocnemius (-81.32%, P=0.001) and to reduce the β-galactosidase-positive area of C2C12 myotubes (-28.74%, P<0.001). NaHS was also found to reverse the expression of muscle atrophy F box protein (MAFbx), muscle-specific RING finger protein 1 (MuRF1), Cyclin D1 and p21 in the ageing gastrocnemius tissue (MAFbx: -31.73%, P=0.008; MuRF1: -32.37%, P=0.003; Cyclin D1: +45.34%, P=0.010; p21: -25.53%, P=0.022) and C2C12 myotubes (MAFbx: -16.38%, P<0.001; MuRF1: -16.45%, P=0.003; Cyclin D1: +40.23%, P<0.001; p21: -35.85%, P=0.026). The AMPKα1-ULK1 pathway was activated and autophagy was up-regulated in NaHS-treated gastrocnemius tissue (p-AMPKα1: +61.61%, P=0.018; AMPKα1: +30.64%, P=0.010; p-ULK1/ULK1: +85.87%, P=0.005; p62: -29.07%, P<0.001; Beclin1: +24.75%, P=0.007; light chain 3 II/I [LC3 II/I]: +55.78%, P=0.004) and C2C12 myotubes (p-AMPKα1: +77.49%, P=0.018; AMPKα1: +26.18%, P=0.022; p-ULK1/ULK1: +38.34%, P=0.012; p62: -9.02%, P=0.014; Beclin1: +13.36%, P<0.001; LC3 II/I: +79.38%, P=0.017; autophagy flux: +24.88%, P=0.034) compared with the D-gal group. The effects of NaHS on autophagy were comparable to those of acadesine and LYN-1604, and chloroquine could reverse its effects on ageing. LC-MS/MS and Co-IP experiments demonstrated that USP5 is a deubiquitinating enzyme of AMPKα1. Following the knockdown of USP5, the activation of AMPKα1 was decreased (p-AMPKα1: -42.10%, P<0.001; AMPKα1: -43.93%, P<0.001), autophagy was inhibited (p-ULK1/ULK1: -27.51, P=0.001; p62: +36.00, P<0.001; Beclin1: -22.15%, P<0.001) and NaHS lost its ability to up-regulate autophagy. NaHS was observed to restore the expression (gastrocnemius: +62.17%, P<0.001; C2C12 myotubes: +37.51%, P=0.003) and S-sulfhydration (+53.07%, P=0.009) of USP5 and reduce the ubiquitination of AMPKα1. H2S promotes the deubiquitination of AMPKα1 by increasing the expression and S-sulfhydration of USP5, thereby up-regulating autophagy and alleviating skeletal muscle ageing.