Objective To explore the influencing factors of perioperative neurocognitive disorders (PND) in the elderly patients with brain tumors and effectiveness of rehabilitation treatment. Methods A retrospective analysis was made of the clinical data of 120 elderly brain tumor patients admitted to First Affiliated Hospital of Xinjiang Medical University from December 2020 to July 2022. Based on whether they experienced PND, the patients were divided into PND group (n=78) and non-PND group (n=42). The two groups were compared in the demographic information and clinical indicators. According to the intervention methods, the PND patients were classified into the control group (n=41) and the observation group (n=37). The two groups were compared in the effects of different intervention methods on improving neurocognitive function and quality of life. SPSS statistics 22.0 was used to process the data, and according to the type of data, t test orχ² test was used for inter-group comparison. Logistic regression model was used to analyze the factors affecting the PND in the elderly patients with brain tumors. Results The incidence of PND in 120 elderly patients with brain tumors was 65.0% (78/120). There was a statistically significant difference in age, tumor location, WHO pathological tumor grading, and tumor volume between PND group and non-PND group (P<0.05). After treatment, the Montreal cognitive assessment (MoCA) score, and the role, physical, social and emotional functions scores in the observation group were higher than those in the control group, and the difference was statistically significant (P<0.05). Multivariate logistic regression analysis showed that the factors affecting the occurrence of PND in the elderly brain tumor patients were tumor site (OR=1.879, 95%CI 1.103-3.203), WHO′s pathological tumor grading (level Ⅱ:OR=1.964, 95%CI 1.021-3.780; level Ⅲ:OR=2.186, 95%CI 1.099-4.349; level Ⅳ:OR=2.462,95%CI 1.162-5.216) and tumor volume (20-＜40 cm³:OR=1.793, 95%CI 1.016-3.166; 40-＜60 cm³:OR=2.038, 95%CI 1.114-3.727; ≥60 cm³:OR=2.207, 95%CI 1.207-4.298). Conclusion The incidence of PND is relatively high in the elderly patients with brain tumors, especially in those with tumors located in the frontal and temporal lobes, high grades on WHO tumor classification and large tumor volumes, and high-risk groups require special attention. After the onset of PND, rehabilitation therapy can help improve neurocognitive function.