Background The pathogenesis of POCD has not been clarified for years. Recent studies suggest that anesthesia may play an important role in the multiple molecular changes associated with POCD. Objective To review the potential links between anesthesia and the multifactorial molecular mechanisms of POCD. Content General anesthetics could induce the production of neurodegenerative proteins，regulate the release of inflammatory mediators，interact with central cholinergic receptors and produce neurotoxic materials. which may all promote the occurance and development of POCD. Trend The relationship between anesthesia and the development of POCD is ambiguous and further research is needed.