【Abstract】Objective To investigate effects of different perioperative analgesia methods on postoperative cognitive function in elderly patients with hip fracture undergoing hip arthroplasty. Methods 122 elderly patients undergoing hip arthroplasty from March 2015 to April 2017 in our hospital were selected and divided into GE group (general anesthesia) and CSEA group (combined spinal epidural anesthesia), according to the analgesia methods. The operative parameters, anesthetic wakefulness time, and VAS score and cognitive function were compared between the two groups. Results The operative time, intraoperative bleeding and postoperative complications between groups had no difference (P＞005). Anesthesia recovery time, extubation time and directional recovery time in CSEA group were shorter than those of the GE group (P＜005). The VAS score was decreased after operation, and was lower in the CSEA group than in the GE group at the same time period (P＞005). The excellent and good rate of anesthesia in CSEA group was higher than that of the GE group (9508% vs 7541%, P＜005). The MMSE score had no difference before operation (P＞005), and were increased after operation, which was higher in the CSEA group than in the GE group (P＜005). The incidence of cognitive dysfunction in CSEA group was 492%, and was lower than that of the GE group (P＜005). The levels of IL6 and TNFα between groups had no difference (P＞005), and were increased after operation, which was lower in the CSEA group than in the GE group (P＜005). Conclusion Both the general anesthesia and combined spinal epidural anesthesia have effect on the postoperative cognitive function in elderly patients with hip fracture undergoing hip arthroplasty, while the incidence of cognitive dysfunction is lower among patients receiving the combined spinal epidural anesthesia than among patients receiving the general anesthesia.