This study focuses on the wayfinding experiences of general elderly users in Tianjin Medical University General Hospital, aiming to identify and optimize the main factors affecting their wayfinding experiences. Initially, hypotheses were proposed and the importance of various factors influencing the elderly users’ wayfinding experiences was quantitatively evaluated by applying Multi-Criteria Decision-Making (MCDM) methods, particularly the Analytic Hierarchy Process (AHP). Subsequently, qualitative research methods, including field surveys, wayfinding tests, and interviews, were employed to collect data and verify the applicability and accuracy of the AHP theoretical assumptions in practical wayfinding experiences. The results revealed key factors affecting the wayfinding experiences of elderly users, such as the complexity of the building structure, the ease of use and comprehensibility of the signage system, and the environmental friendliness. Finally, based on these key factors, targeted improvement suggestions and design guidelines for the wayfinding system in Tianjin Medical University General Hospital were proposed.