Objective To investigate the effect and safety of enhanced recovery after surgery (ERAS) in the elderly patients undergoing laparoscopic-assisted radical gastrectomy. Methods From December 2015 to December 2018,80 patients undergoing laparoscopic-assisted radical gastrectomy were randomly divided into ERAS group and routine group (n=40 in each). The two groups were compared in postoperative indicators and complications. SPSS statistics 22.0 was used to analyze the data, and depending on data type, t test or χ² test was used for comparison between the two groups. Results Compared with the routine group, the ERAS group had shorter time before the first exhaust [(53.77±23.53) vs (64.24±22.44)h] and the first defecation [(60.92±22.15) vs (75.10±22.25)h]; earlier ambulation [(18.77±3.27) vs (26.67±4.29)h], oral feeding for liquids [(22.26±9.64) vs (89.47±13.39)h], postoperative parenteral nutrition[(5.43±1.57) vs (7.46±1.45)d] and removal of peritoneal drainage [(4.90±1.24) vs (6.60±1.04)d]; shorter postoperative hospital stay [(8.73±1.80) vs (10.83±2.07)d]; and lower postoperative hospitalization expenses [(5.35±0.58)×10⁴ vs (6.06±0.65) ×10⁴ yuan], all differences being statistically significant (P<0.05). ERAS group had significantly lower incidences than the routine group of sore throat [7.5%(3/40) vs 27.5%(11/40)], incision pain above grade Ⅱ[5.0%(2/40) vs 20.0%(8/40)], and postoperative complications of Clavien-Dindo grade Ⅰ [17.5%(7/40) vs 37.5%(15/40)], all differences being statistically significant (P<0.05). Conclusion ERAS is safe and effective in the elderly patients undergoing laparoscopic-gastric radical gastrectomy and can reduce postoperative Clavien-Dindo grade Ⅰ complications.