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OBJECTIVES To add evidence to the relationship between multimorbidity and healthcare expenditure. METHODS The study population comprised patients aged ≥60 in Beijing, covered by the Urban Employee Basic Medical Insurance (UEBMI) (N = 30,774). Multimorbidity was measured with 33 chronic conditions confirmed by doctors. Multivariate linear regression was performed. RESULTS The prevalence of multimorbidity was 82% among elderly patients in Beijing and was higher in older and female patients. About 95% of the healthcare expenditure on the 33 conditions was spent on multimorbid patients. In the multivariate analysis, after inclusion of demographic characteristics, disease severity, and health facility level, the expenditure increased significantly with the number of chronic conditions. After further including condition types, the coefficients of the number of conditions were much lower than those in previous models. The expenditure on patients with two and three conditions was 3.4 times (95% CI: 3.2-3.7) and 5.3 times (95% CI: 4.7-6.0) higher than that on patients with a single condition, respectively; however, the expenditure did not significantly increase after three conditions. CONCLUSIONS Multimorbidity is common among elderly patients in Beijing and consumes the majority of the healthcare resources. The health delivery system in China and other low- and middle-income countries needs to pay more attention to multimorbidity.