Objective To compare the effects of 3 different anesthesia methods (general anesthesia, peripheral nerve block combined with laryngeal mask general anesthesia, and peripheral nerve block combined with basal anesthesia) on intraoperative vital signs and postoperative recovery in elderly patients with hip fracture. Methods A total of 60 elderly patients undergoing elective hip fracture surgery admitted in Hainan Hospital of Chinese PLA General Hospital were subjected, and divided into 3 groups according to different anesthesia methods:general anesthesia group (G group), peripheral nerve block combined with laryngeal mask general anesthesia group (NL group) and peripheral nerve block combined with basal anesthesia group (NS group). Vital signs and dosages of anesthetic agents were observed and recorded during the surgery. Ramsay grade was used to evaluate the sedation levels at the time of awakening, 5 min after awakening and out of operating room. Visual analogue scale (VAS) was applied to evaluate analgesia levels at the above time points and 24 h postoperatively. Mini-mental state examination (MMSE) and Montreal cognitive assessment (MoCA) were employed to evaluate cognitive function in 1 d before and 5 d after the surgery. Postoperative feeding time (h) and time of getting out of bed (d) were also recorded. Results There were no significant differences in general data of patients among the 3 groups. The consumption of sufentanilin G group was significantly higher than that in NL group (P<0.001), and that in NL group was obviously higher than that in NS group (P<0. 001). After 10 min of anesthesia, MAP in G group (P=0.003) and NL group (P=0.007) was significantly lower than that in NS group, while MAP in G group was significantly higher than that in NL group and NS group (P=0.005; P=0.016) immediately after resuscitation and 5 min after resuscitation. Immediately after resuscitation, HR in G group was significantly higher than that in NS group (P=0.015). BIS in G group and NL group was significantly lower than that in NS group (P<0.05) at 5min and 10min after completion of anesthesia, at the beginning and the end of operation and after leaving the operating room. At the moment of awakening, Ramsay grade was significantly higher in G group than NS group (P<0.05), and VAS grade was significantly higher than NS group (P<0. 05). There were no differences in MMSE and MoCA points in 1 d before and 5 d after surgery among the 3 groups (all P>0.05). Postoperative feeding time (h) in G group was significantly longer than that in NS group (P=0.048) and NL group (P=0.012). Conclusion Peripheral nerve block combined with basal anesthesia can achieve better analgesic effectiveness, has light effect on the patient′s cognition, shortens postoperative feeding time significantly and promotes early postoperative clinical recovery in elderly patients under going hip fracture surgery.