Objective: To identify prognostic factors in elderly patients with severe pneumonia using multivariate logistic regression analysis and evaluate the medical value of continuous monitoring of serum oxidative stress levels, with a focus on implications for physical recovery and rehabilitation. Methods: A retrospective analysis was conducted on 200 elderly patients with severe pneumonia admitted to a tertiary hospital. Clinical and laboratory data, including serum oxidative stress markers (malondialdehyde [MDA] and superoxide dismutase [SOD]), were collected. Multivariate logistic regression analysis was used to identify prognostic factors for adverse outcomes, such as prolonged hospital stay, reduced functional capacity, and mortality. Oxidative stress levels were continuously monitored, and their correlation with clinical outcomes and recovery metrics was assessed. Results: Key prognostic factors identified included advanced age, higher C-reactive protein (CRP) levels, elevated serum MDA, reduced SOD activity, and presence of comorbidities (P < 0.05). Continuous monitoring of oxidative stress markers revealed significant correlations between elevated MDA levels, decreased SOD activity, and adverse outcomes such as longer hospitalization and delayed physical recovery. Patients with improved oxidative stress profiles demonstrated faster recovery and better functional outcomes, including improved mobility and reduced fatigue. Conclusion: Multivariate logistic regression analysis identified serum oxidative stress markers as significant prognostic factors in elderly patients with severe pneumonia. Continuous monitoring of oxidative stress provides valuable insights for predicting recovery trajectories and optimizing rehabilitation strategies. These findings highlight the importance of integrating oxidative stress management into multidisciplinary care approaches, particularly for enhancing physical recovery and improving quality of life in elderly patients. Further research is needed to explore the role of targeted interventions, such as antioxidant therapy and tailored physical activity programs, in mitigating oxidative stress and promoting functional recovery.