Objective To analyze the risk factors for postoperative reintubation in the elderly patients following spinal operation under general anesthesia. Methods A retrospective study was performed on 670 patients receiving spinal surgery in our hospital from January 2010 to December 2015. According to reintubation or not after planned extubation, they were assigned into reintubation group (n=11) and non-reintubation group (n=659). The clinical data were collected and analyzed to obtain risk factors for reintubation. SPSS statistics 18.0 was used to perform the statistical analysis. Univariate and multivariate logistic regression analysis were employed for reintubation-related risk factors. Results The incidence rate of reintubation was 1.64%(11/670) in the cohort. Univariate analysis showed that gender, body mass index (BMI), physical status of American Society of Anesthesiologists (ASA) classification, preoperative pulse oxygen saturation (SpO₂), upper respiratory infection for 2 weeks before operation, chronic obstructive pulmonary disease (COPD), emergent operation, operative sites, hemoglobin ≤90 g/L in 30 min postoperatively, and operation time were associated with reintubation after spinal surgery (P<0.05). Multivariate logistic regression analysis indicated that ASA classification ≥Ⅲ (OR=9.65, 95%CI 2.362-29.384, P<0.05), operation time ≥4 h (OR=9.485, 95%CI 1.620-88.002, P<0.05), and COPD (OR=13.25,5%CI 5.852-37.251, P<0.05) were risk factors for postoperative reintubation in these subjects. ConclusionASA classification ≥Ⅲ, operation time ≥4 h, and COPD are risk factors for postoperative reintubation in the elderly patients after spinal operation under general anesthesia.