In the context of its economy, the problem of aging society has become increasingly prominent in China. How to scienti-fically select anesthetics with consideration of ensuring the perioperative safety of the elderly patients has become one of the most urgent problems for anesthesiologists. The elderly usually experience declining physiological function of various systems and weakening compensatory ability of important organs. Esketamine, the dextrorotatory isomer of ketamine, produces good sedative, analgesic, and antidepressant effects by non-competitive inhibition of N-methyl-D-aspartate receptors, with a good protective effect for the nervous, circulatory and respiratory systems. It promises a good prospect in anesthesia in the elderly patients. This article reviews the progress in clinical research of esketamine for anesthesia in the elderly patients.