Objective To analyse the clinical feasibility of low-dose bupivacaine with fentanyl for combined spinal-epidural anesthesia in elderly patients. Methods Sisty elderly patients undergoing elective underbelly and lower limbs operations were randomized into two groups(n=30):The Study Group received spinal anesthesia with a combination of low-dose bupivacaine and fentanyl ,while the Control Group received bupivacaine. The block effects were assessed. The incidence of hypotension, arrhythmia, nausea and vomiting, and shivering and the need of ephedrine due to hypotension were observed. Results All patients had adequate anesthetic effect. The incidence of hypotension, arrhythmia, nausea and vomiting, shivering in Study Group was significantly lower than in Control Group. The need of ephedrine due to hypotension was less in Study Group. Conclusion Low-dose bupivacaine with fentanyl for spinal-epidural block in elderly patients may maintain the cardiovascular stability and reduce the side-effects.