Objective: To comparatively analyze the clinical value of levofloxacin versus moxifloxacin in the treatment of elderly patients with community-acquired pneumonia (CAP). Methods: Elderly patients with CAP admitted to the hospital from June 2023 to June 2025 were selected and randomly divided into group A and group B, with 55 cases in each group. Both groups were given basic treatment. Meanwhile, group A was treated with levofloxacin and group B was treated with moxifloxacin. After 14 d of treatment, the two groups were compared on total clinical effective rate, bacterial clearance rate, time to symptom resolution, inflammation indicators, and incidence of adverse drug reactions. Results: The total clinical effective rate in group B was higher than that in group A (94.55% vs. 80.00%, P < 0.05). The bacterial clearance rate in group B was comparable to that in group A (88.64% vs. 72.73%) (P > 0.05). The time to resolution of symptoms such as fever, cough, pulmonary moist rales, and purulent sputum was shorter in group B than in group A (P < 0.05). After treatment, the levels of procalcitonin (PCT), soluble triggering receptor expressed on myeloid cells-1 (sTREM-1), periostin, and interleukin-6 (IL-6) in group B were lower than those in group A (P < 0.05). The incidence of adverse drug reactions in group B was comparable to that in group A (7.27% vs. 16.36%) (P > 0.05). Conclusion: Moxifloxacin is more effective to treat elderly patients with CAP. It can significantly accelerate the resolution of clinical symptoms and alleviate inflammatory response.