A retrospective study 94 cases of elderly patients with biliary tract disease. The overall postoperative mortality rate was 6.4%. Among the 94 cases there were 50 cases of acute cholecystitis, of which 15 cases were complicated by acute obstructive suppurative cholangitis, and 44 cases of chronic cholecystitis. 80 cases had gallstones (85.1%). Associated diseases were found in 56 cases (59.6%) before operation, most of them were cardiovascular diseases (53.2%). During operation 23 cases were monitored by ECG, and abnormal ECG developed in 6 cases although the operations were all carried out uneventfully. It is suggested that after adequate preoperative preparation, aggressive surgical intervention should be considered for acute biliary tract disease in elderly patients.