Objective To compare the effects of general anesthesia (GA) versus regional block anesthesia (RA) on the postoperative outcome in the elderly patients with lower limb ischemia. Methods The clinical data of 56 elderly patients with lower extremity ischemia surgically treated in our hospital from January 2013 to March 2021 were collected and analyzed retrospectively. The patients were divided into GA group (n=28) and RA group (n=28) according to the anesthesia method they underwent. The gender, age, modified cardiac risk index (RCRI), anesthesia method, intraoperative hemodynamic indexes postoperative length of hospital stay (LOS), and incidence of postoperative complications were recorded and compared between the 2 groups. SPSS statistics 19.0 was used for data analysis. Multivariate logistic regression or linear regression analysis was used to analyze the effects of different anesthesia methods on myocardial injury (MINS), intraoperative blood pressure fluctuation and postoperative LOS in the patients. Results Among the 56 patients, 18 (32.1%) developed MINS, including 12 (42.9%) in the RA group and 6 (21.4%) in the GA group. But there were no significant differences in the incidence of MINS and postoperative LOS between the 2 groups (both P>0.05). The fluctuation of intraoperative blood pressure was significantly lower in the RA group than the GA group (P<0.05). Female was an independent risk factor for postoperative MINS in the patients (OR=0.191,95%CI 0.051－0.720; P=0.015). Anesthesia mode was not a risk factor affecting MINS and LOS. The RA group had more stable intraoperative hemodynamics than the GA group. Conclusion Female is an independent risk factor for postoperative MINS in the elderly patients with lower limb ischemia. Anesthesia mode has no significant effect on the occurrence of MINS and post-operative LOS, but the hemodynamics in RA group is more stable.