Purpose: This study of this study was to identify factors influencing the burden of main family caregivers who take care of elderly patients with brain and spinal diseases. Methods: This was conducted as descriptive research and data were collected from 255 main family caregivers who were taking care of elderly patients with brain and spinal diseases from 4 hospitals in Daegu and Gyeongbuk Province. Stepwise-multiple regression was used to identify the influencing factors of burden felt. Results: As the score of burden felt by the main family, economic, social, physical, interdependent and emotional burdens were high in order. Factors influencing burden felt by main family care givers taking care of elderly patients with brain and spinal diseases were changed relation with patient after hospitalization, daily life ability, marital status, education and family caregiver`s personality (explanatory power of 24.6%). Family caregivers felt a heavier burden when their relation with the patient was changed negatively or when the patient`s activity of daily living was low. Conclusion: Based on these results, we need to develop coping measures and interventional programs for reducing the burden felt by the main family caregivers of elderly patients with brain and spinal diseases.