Objective To investigate the effect of preoperative nutritional status on the quality of early postoperative recovery in elderly patients undergoing laparoscopic surgery. Methods A total of 100 elderly patients who underwent laparoscopic surgery in Xuzhou cancer hospital from February to November 2022 were selected as the study subjects, and the nutritional status of all patients was evaluated using the mini nutritional assessment scale (MNA) preoperatively, the patients were divided into the undernourished group (group M) and the well nourished group (group N) according to whether the nutritional status score was ≥ 24 points, and the patients' early recovery quality scores were recorded on the preoperative day, as well as on postoperative days 1, 3, and 7, I.e., qor-40 scale (including five aspects of physical comfort, emotional status, psychological support, self-care ability and pain), and multiple linear regression regression was applied to determine whether there was a linear relationship between preoperative nutritional status and early postoperative recovery quality in elderly patients undergoing laparoscopic SG. Results There were no significant differences between the two groups in the preoperative general data, such as age, gender, height, mean blood pressure, smoking history, drinking history, Charlson comorbidity index (CCI), lymphocyte count, urea level, and type of surgery (P 0.05), and the values of indicators reflecting the nutritional status of the patients in the undernutrition group, such as weight, BMI, AC, CC, albumin, hemoglobin, and MNA score, were lower than those in the well nutrition group (P 0.05); The intraoperative data such as sufentanil, remifentanil, and propofol dosage, net intraoperative fluid intake, intraoperative blood loss, incidence of intraoperative hypotension, use of vasoactive drugs, incidence of perioperative blood transfusion, and operative time were not significantly different between the two groups (P 0.05); Within a week after surgery, the quality of postoperative recovery of patients in both groups improved gradually (P 0.05), in which the qor-40 scores in physical comfort, emotional status, psychological support, self-care ability and pain in the group with poor nutrition on days 1, 3 and 7 after surgery were lower than those in the group with poor nutrition (P 0.05). Multiple linear regression analysis indicated that there was a correlation between the nutritional status of patients before surgery and their early recovery quality on postoperative days 1, 3, and 7 (P 0.05). Conclusions The preoperative nutritional status level obtained by MNA score has a good warning effect on the quality of early postoperative recovery in elderly laparoscopic surgery patients, and a suboptimal preoperative nutritional status may not benefit the early postoperative recovery of elderly laparoscopic surgery patients.