Objective To investigate the effects of curculigoside on postoperative cognitive function and its antioxidant and anti‑apoptotic effects in elderly rats. Methods Thirty rats were divided into two groups (15 in each group) according to the random number table method: perioperative neurocognitive disorders (PND) group and PND+curculigoside group. PND model was established according to the references, sevoflurane was inhaled into rats in PND group and PND+curculigoside group for abdominal exploration. Rats in PND+curculigoside group were given curculigoside (50 mg/kg) intragastric administration after operation, once a day for consecutive 7 days; PND group was given the same amount of normal saline. The target quadrant residence time and platform crossing times of the water maze were recorded, hematoxylin‑eosin (H‑E) staining was used to detect hippocampal injury, and enzyme‑linked immunosorbent assay (ELISA) was used to detect superoxide dismutase (SOD) and malondialdehyde (MDA) levels, the apoptosis index of hippocampal neurons was detected by terminal deoxynucleotidyl transferase‑mediated dUTP‑biotin nick end labeling (TUNEL) staining and the phosphorylation level of protein kinase B (Akt) was detected by Western blot. Results Compared with PND group, the target quadrant residence time, the number of platform crossing were significantly increased (P<0.05), hippocampal tissue damage was reduced, phosphorylated‑Akt (p‑Akt) and Akt were increased (P<0.05), SOD level and Akt phosphorylation level were significantly increased (P<0.05), MDA and apoptosis index were significantly decreased (P<0.05) in PND+curculigoside group. Conclusions Curculigoside can inhibit oxidative stress and protect hippocampal neurons from apoptosis, and improve the cognitive function of elderly PND rats.