Objective To evaluate the efficiency of covered stent implantation on the elderly patients with coronary perforation occurred in percutaneous coronary intervention (PCI). Methods From June 2004 to June 2011, 8 cases having coronary perforation during PCI received covered stents implantation. They were followed up for 1 year for the occurrence of major adverse cardiac events (MACE). Results There were 4 males and 4 females with an age ranging from 65 to 76 years [mean (70.4±4.1) years]. Average diameter of implanted covered stents was (3.2±0.3)mm, and average length was (21.0±3.4)mm. In all patients, perforation was successfully closed, while no patient died in the procedure. One patient with acute anterior myocardial wall infarction died of multiple organ failure due to lung infection at day 19 after PCI. No patient had angina pectoris during 1 year follow-up. Both of mortality and MACE rate were 12.5% (1/8) in 1 year after PCI. Conclusion Treatment of covered stent in elderly patients with coronary perforation can achieve good efficacy.