Abstract:With the global acceleration of population aging，the demand for surgical procedures among elderly patientscontinues to rise，presenting unprecedented challenges and opportunities for the field of anesthesiology. Due to age?related decline in organ function，high burden of comorbidities，and altered pharmacokinetics，perioperativemanagement in elderly patients differs significantly from that in younger populations. This review focuses on thephysiological characteristics of elderly patients and systematically discusses key aspects of preoperative assessment，principles for the selection of anesthetic techniques and agents，key intraoperative management strategies，andpostoperative recovery and control of complication. In light of current research trends，the article further explorespriorities and directions for optimizing geriatric anesthesia，aiming to provide a clinical reference and enhance anestheiasafety and perioperative outcomes for elderly patients.