As the population aging and prolonged life expectancy, there would be more and more surgical operations for the elderly in China. Besides organ dysfunction, the elderly also simultaneously suffered many comorbidities, such as stroke, cardiac ischemic disease, hypertension and diabetes. The specific characteristic of the elderly increases the incidence of postoperative complications and mortality, and presents a big challenge for perioperative management. Anesthesiologists may play important role in improving outcome of the elderly patients by optimizing perioperative management.