Objective To analyze the clinical data of the elderly undergoing pancreaticoduonectomy (PD) and investigate the safety of the surgery. Methods Clinical data of 90 over 50-year-old patients undergoing PD for pancreatic and periampullary cancer in our department from 2007 to 2011 were collected and retrospectively analyzed. They were divided into two groups according to their age, that is, ≥70-year-old group (n＝27) and＜70-year-old group (n＝63). Their indices, including pre-operative Karnofsky Performance Status (KPS), hemoglobin (Hb), hematocrit (Hct), albumin (ALB), serum total bilirubin (TBIL), prealbumin (PALB), blood glucose, serum potassium, operation time, blood loss during operation, rate of postoperative intensive care unit (ICU) stay, duration of postoperative hospital stay, incidence of postoperative complications, and postoperative mortality, were analyzed and compared. Results The ≥70-year-old group had significantly lower KPS score [(71.11±6.98) vs (85.40±6.43), P＝0.00], ALB [(34.86±4.54) vs (37.02±4.13)g/L, P＜0.05], PALB [(127.36±41.19) vs (160.27±57.11)g/L, P＜0.05], and serum potassium [(3.38±0.48) vs (3.81±0.45)mmol/L, P＜0.01], but obviously higher blood glucose [(8.47±3.68) vs (6.41±2.12)mmol/L, P＜0.05], and postoperative rate of ICU stay (81.5% vs 39.68%, P＜0.01) when compared with ＜70-year-old group. The incidence of postoperative complications was higher in ≥70-year-old group than in the other group, though without significant difference (48.15% vs 39.42%, P＞0.05). No patient died after PD ≥70-year-old, but two patients died due to complications in ＜70-year-old group within 30d after operation. Conclusion It is feasible and safe to perform PD to elderly patients after careful patient selection, physical fitness improvement, and life-supporting treatment after operation.