OBJECTIVE： To explore the effect of subarachnoid block anesthesia in endoulogy minimally invasive surgery of elderly patients. METHODS： 198 elderly patients underwent endoulogy minimally invasive surgery were randomly divided into observation group （100 cases） and control group （98 cases）. Observation group received subarachnoid block anesthesia， and control group received epidural anesthesia. The anesthesia onset time， anesthesia dose， surgery time， complete block time， satisfaction degree of anesthesia effect， the occurrence of ADR were compared between 2 groups. RESULTS： Anesthesia onset time and complete block time of observation group were （1.5±0.6） min and （7.9±3.9）min， which were significantly shorter than those of control group （4.5±1.2） and （17.5±4.3） min， with statistical significance （P＜0.05）. The anesthesia dose of observation group was （20.2±4.8）mg， which was significantly lower than that of control group [（103.4±20.1）mg]， with statistical significance （P＜0.05）； the satisfaction degree of anesthesia effect was 95.0％ in observation group， which was significantly higher than that of control group （69.4％）， with statistical significance （P＜0.05）； there was no statistical significance in surgery time and the incidence of ADR between observation group and control group （P＞0.05）. CONCLUSIONS： Subarachnoid block anesthesia consumes small dose， acts rapidly and shows significant anesthesia effect， it is used for endoulogy minimally invasive surgery of elderly patients.