Background　The use of regional anesthesia for elderly surgical patients has recently become increasingly popular．However, the benefits of regional anesthesia on postoperative neurological function and mortality of elderly patients is still in controversy.　Objective　Review the clinical evidences of regional anesthesia and general anesthesia on postoperative neurological function and mortality in elderly surgical patients．　Content　This review summarizes the impact of regional anesthesia and general anesthesia on postoperative mortality，incidence of cognitive dysfunction, delirium, perioperative stroke, pulmonary and cardiovascular complications in elderly surgical patients.　Trend　Regional nerve block may reduce the incidence of postoperative pulmonary complications, early postoperative cognitive dysfunction in elderly surgical patients, it is not certain whether regional nerve block can reduce the incidence of postoperative mortality, cardiovascular complications and perioperative stroke. The relationship between nerve block and the postoperative outcomes of elderly patients remains to be further studied.