Objectives: To evaluate the application of paravertebral nerve block in the hip joint operation of elderly patients. Methods: 65 patients aged over 70 undergoing hip joint operation were randomly divided into tracheal intubation under general anesthesia group (GA) and paravertebral nerve block (PVB) group. Perioperative anaesthetic effect and the outcome of two groups were compared. Results: Patients in Group PVB showed stable heart rate and average arterial blood pressure, and the cases needing postoperative intensive care unit ( ICU ) monitoring, lower respiratory tract infection or indwelling catheter were lower , which had significant statistical difference compared with Group GA (P<0.05). Conclusions: PVB could be effectively used in the hip joint operation of elderly patients, associated with minor physiological disturbance, higher postoperative comfort and safety.