Abstract: Objective To compare the effect of intravenous anesthesia and inhalation anesthesia on postoperative cognitive function in elderly patients. Methods A total of 160 elderly patients undergoing surgery in our hospital were randomly divided into intravenous anesthesia group and inhalation anesthesia group according to random number table method. The intravenous anesthesia was maintained by 0.1 g/kg(kg·min)of fentanyl and 4 mg/(kg·h)of propofol in the intravenous anesthesia group, and by 50% N₂O and sevoflurane inhalation in inhalation anesthesia group. The Mini-mental State Examination(MMSE)was used to assess the score of cognitive function of patients before surgery and 1, 4, 12 and 24 h after surgery. The extubation time, awake time and response time were observed and recorded. Results Before surgery, there was no significant difference in MMSE score(P>0.05); at 1, 4, 12 and 24 h after surgery, MMSE scores of intravenous anesthesia group were significantly higher than that of inhalation anesthesia group(P<0.05); there were no statistically significant differences in the amount of intraoperative blood loss, number of transfusion cases, operation time, occurrence of hypotension, and the incidence of postoperative nausea and vomiting between the two groups(P>0.05); the extubation time, response time and awaking time of patients in the intravenous anesthesia group were significantly shorter than those in the inhalation anesthesia group(P<0.05). Conclusion Compared with inhaled anesthesia, intravenous anesthesia can significantly shorten the postoperative extubation time, response time and awake time of elderly patients, and reduce the impact of anesthesia on patients' cognitive function.