Objective To evaluate the application of rigid bronchoscope and intubated laryngeal mask airway ventilation in elderly patients with central bronchogenic carcinoma based on respiratory endoscopic intervention. Methods A total of 86 elderly patients with central bronchogenic carcinoma who underwent respiratory endoscopic intervention were selected and their clinical data were retrospectively analyzed. According to their ventilation modes, the patients were divided into two groups: a rigid bronchoscope group (group Y, n=44) and an intubated laryngeal mask group (group L, n=42). Their pulse oxygen saturation (SpO2), heart rate, systolic blood pressure (SBP) and mean arterial pressure (MAP) when the patients entered into the room (T0), at the insertion of the ventilation tube (T1), at the beginning of endoscopic intervention (T2), at the withdrawal of the tube (T3), and at the removal of the ventilation tube (T4) were recorded, and the arterial systolic pressure variation (SPV) was calculated. The time to postoperative recovery, the time to withdraw the ventilation tube, the percentage and total dosage of ephedrine, the number of manually assisted ventilation, the incidences of oral and throat injury, as well as the satisfaction of endoscopic interventional surgeons and patients toward endoscopic intervention were recorded. Results Compared with those at T0, patients in group L showed decreases in SPV at T1‒T4 (all P<0.05), while group Y presented increases in SBP, heart rate and MAP at T1, T2 and T4 (all P<0.05), as well as decreases in SPV at T3 and T4 (all P<0.05). SPV in group L was lower than that in group Y at T3 and T4 (all P<0.05). No statistical difference was found as to SpO2 at each time point between the two groups (all P>0.05). Compared with group Y, group L presented decreases in the recovery time, the time to withdraw the tube, the percentage and total dosage of ephedrine, the incidence of oral and throat injury, and the number of manually assisted ventilation (all P<0.05), as well as increases in the satisfaction of patients and endoscopic interventional surgeons (all P<0.05). Conclusions Intubated laryngeal mask ventilation mode and rigid bronchoscope have advantages and disadvantages in the endoscopic intervention of elderly patients with central bronchogenic lung cancer. Ventilation strategies more suitable for elderly patients should be determined after discussion with respiratory physicians based on the cardiopulmonary function of patients and the size and location of tumors.