Objective To investigate whether the intraoperative fluid therapy based on the parameters of arterial pressure wave analysis (FloTrac) could reduce the incidence of postoperative complications in the elderly patients after major surgery. Methods This was a prospective, open-labeled, randomized controlled trial. One hundred thirty-eight patients at an age of ≥65 years who were scheduled for major abdominal surgeries in our department from October 2013 to November 2014 were randomized into 2 groups. In the control group, routine monitoring was performed and intraoperative fluid therapy was administered according to conventional practice. In the goal-directed therapy (GDT) group, hemodynamic monitoring was performed using the FloTrac/Vigileo system, and the intraoperative goals were to maintain stroke volume variation (SVV)＜13%, cardiac index (CI) ≥2.5 L/(min·m2), and mean arterial pressure (MAP) ≥65mmHg. Results The incidence of postoperative cardiovascular complications was significantly lower in the GDT group than in the control group[2.9%(2/69) vs 11.6%(8/69), P＝0.049]. The incidence of postoperative infectious complications was slightly lower in the GDT group than in the control group, but the difference was not statistically significant [13.0%(9/69) vs 26.1%(18/69), P＝0.053]. There was no significant difference between the 2 groups with regard to the overall incidence of postoperative complications. Conclusion For the elderly patients undergoing major abdominal surgery, intraoperative GDT based on arterial pressure wave analysis decreases the incidence of postoperative cardiovascular complications, and also tends to decrease the incidence of postoperative infectious complications after surgery. However, its effects on the outcomes of the elderly need further study on larger samples.