Background More non-depolarizing muscle relaxants had been used in elderly patients in recent years. Objective Based on the analysis of domestic and international references, we reviewed the progress of the pharmacodynamic and pharmacokinetic changes of elderly patients with non-depolarizing muscle relaxants. Content The physiological changes in the elderly patients had effected on the absorption, distribution, metabolism and excretion of non-depolarizing muscle relaxants, thus the onset time, clinical duration and full recovery are different in elderly patients after used different kinds of non-depolarizing muscle relaxants. Trend Although it can increase the risk of residual paralysis and lung complications, a targeted selection of non-depolarizing muscle relaxants and a intensive perioperative monitoring and management can effectively reduce the side effects and harm of non-depolarizing muscle relaxants in elderly patients.