Objective To compare if there is a significant change in the rate of tracheal intubation at terminal period in elderly patients before and after the promotion of the concept of “palliative care”. Methods A retrospective study was conducted to investigate the medical records of dead patients aged ≥65 years who died in our medical center from January 2008 to December 2017. The patients were divided into cancer group and non-cancer group. The rate of tracheal intubation in the 2 groups was recorded year by year, and the rate was compared before and after 2014. And the intubation rate and survival time after intubation were also compared. SPSS statistics 21.0 was used for statistical analysis. Data comparison between 2 groups was performed using student′s t test or Chi-square test depending on data types. Results Finally, medical data of 1233 dead elderly patients were collected, including 1150 males (93.27%) and 83 females (6.73%), and 456 cases (36.98%) of them were cancer patients and 777 cases (63.02%) were non-cancer patients. The patients of the cancer group had a significantly younger mean age and larger proportion of younger age subgroup when compared with those of the non-cancer group (both P<0.05). Among the 965 cases (78.26%) receiving tracheal intubation, 29.22% cases (282/965) of them were from the cancer group, and 70.78%(683/965) from the non-cancer group. The rate of tracheal intubation was 61.84%(282/456) in the cancer group and 87.90%(683/777) in the non-cancer group, with statistical difference between them (P<0.01). When the conditions were compared before and after 2014, significant differences were seen not only in the overall rate of tracheal intubation [557 (82.76%) vs 408 (72.86%)], but also in the rate of the cancer group [194 (69.04%) vs 88 (50.29%)] and that of the non-cancer group [363 (92.60%) vs 320 (83.12%), all P<0.01]. The mean survival time after intubation was (108.09±16.40) d in the cancer group and (273.93±20.20) d for the non-cancer group, and the difference was statistically significant (P<0.01). Within 1 month after tracheal intubation, 56 cases (54.96%) of the cancer group and 100 cases (42.90%) of the non-cancer group died. Nineteen cases (6.74%) from the cancer group and 146 cases (21.38%) out of the non-cancer group survived longer than 1 year after intubation (P<0.01). Conclusion The overall rate of tracheal intubation is relatively high among the dying elderly patients in our center. After the promotion of the concept of “palliative care” from 2014, the rate is significantly decreased in either cancer or non-cancer patients. The survival time after intubation is greatly longer in the non-cancer patients than the cancer patients. A scientific assessment system should be established to strictly evaluate the necessity of intubation.