Abstract: Objective：To evaluate the influence of subarachnoidal anesthesia on early postoperative cognitive function in elderly patients in Department of Orthopedics. Methods：A total of 120 elderly patients were enrolled in this study from January 2013 to May 2016 Jiangbei People’s Hospital. All patients were randomly divided into the observation group and the control group, with 60 cases in each group. Patients in the observation group received subarachnoidal anesthesia, while patients in the control group received general anesthesia. The minimental state examination (MMSE) was used to evaluated the cognitive function of 1 day before surgery and first, third and fifth day after surgery. The incidence rate and severity level of postoperative cognitive dysfunction (POCD) in two groups were compared. Results：Five days after surgery, the cumulative incidence of POCD in the observation group was 21.7%（13/60）, which was significantly lower than that in the control group 46.7%（28/60）(P＜0.05). Further analysis showed that MMSE scores at different time points postoperation were significantly reduced by comparison with that before operation in both group, while the MMSE scores in the observation group after surgery were significantly higher than those of the control group (P＜0.05). Conclusions：Comparing with general anesthesia, subarachnoidal anesthesia is effective to reduce the incidence and severity of POCD in elderly patients receiving orthopedic surgery, and it beneficial to patient’s cognitive functional recovery.