Objective To investigate the application of mivacurium chloride in tracheal intubation for the elderly patients and its effect on patients′ heart rate (HR) and mean arterial pressure (MAP). Methods A total of 60 elderly patients admitted in our hospital from August 2016 to August 2018 were recruited prospectively, and then randomly divided into mivacurium chloride group (n=30) and atracurium group (n=30). The onset time of muscle relaxant, and 25% recovery time from intravenous injection of muscle relaxant to train of four stimulation (TOF), and HR, MAP, bispectral index of electroencephalogram (BIS), serum levels of norepinephrine (NE) and histamine (HIS) before anesthesia (T0), 1min (T1) and 2min (T2) after intravenous injection of muscle relaxant, immediately before intubation (T3) and immediately after intubation (T4) were compared between the 2 groups. SPSS statistics 21.0 was used to perform the statistical analysis. Results The onset time of muscle relaxants [(211.3±32.5) vs (383.5±34.5)s] and recovery time from intravenous injection of muscle relaxants to 25% of TOF [(23.5±4.5) vs (40.4±6.4)min] were significantly shorter in the mivacurium chloride group than in the atracurium group (P<0.05). At T4, the patients of the mivacurium chloride group had statistically lower HR [(84.3±13.8) vs (94.5±15.4)beats/min], MAP [(94.3±13.8) vs (104.7±9.2)mmHg(1mmHg=0.133kPa)], BIS [(55.7±6.8) vs (60.2±7.0)] and NE level [(654.7±165.3) vs (766.0±100.0)ng/ml] when compared with those from the atracurium group (P<0.05). What′s more, the serum HIS levels of the mivacurium chloride group were notably higher than those of atracurium group (P<0.05) at T1 [(1.31±0.17) vs (0.56±0.05)ng/ml], T2 [(1.04±0.15) vs (0.55±0.03)ng/ml], T3 [(0.79±0.09) vs (0.54±.03)ng/ml], and T4[(0.67±0.08) vs (0.56±0.04)ng/ml]. Conclusion Mivacurium chloride is better than atracurium cis-besylate in the application of tracheal intubation in elderly patients, and can maintain the stability of HR and MAP of patients more effectively.