Background　With increasing age, physiologic changes and comorbidities appears in elderly patients. The risk and complexity of thoracic anesthesia for elderly patients were increased.　Objective　To review recent progress of thoracic anesthesia in geriatric patients in order to improve anesthesia quality.　Content　The function and comorbidity of cardiopulmonary system should be evaluated before anesthesia. Anesthesia plan should be individualized according to the condition of patients. Current evidence support the use of inhalational anesthesia, combined with epidural block. During one-lung ventilation, pulmonary protective strategy and recruitment maneuver should be adopted. Goal directed fluid therapy should be used to guide circulatory management. Satisfied postoperative analgesia should be provided after suregry.　Trend　For elderly patients undergoing thoracic surgery, careful perioperative management will improve outcome after surgery.