Abstract: Objective To explore the secure and effective surgical methods for elderly(>70 years old) hypopharyngeal carcinoma patients. Methods A retrospective analysis of the clinical materials of 85 elderly hypopharyngeal carcinoma patients was conducted from Otolaryngology Head and Neck Surgery Department of the First Affiliated Hospital of Anhui Medical University. Sixty-eight cases were in surgery group and the other 17 cases were in non-surgery group. Kaplan-Meier method was used to calculate the survival rate and chi-square test was used to compare the complication rate and decannulation rate between two groups. Results The 5-year survival rate of patients in the surgery group was 38.2%(26/68) and in the non-surgery group was 5.9%(1/17), with significant difference (P=0.005). In the surgery group, the 5-year survival rate of patients from 70 to 75 years old was 38.6%(17/44), while patients over 75 years old was 37.5% (9/24), without significant difference(P=0.26).In the surgery group, 45 cases had laryngeal function preservation and restored breathing, swallowing and pronouncing functions after surgery, while the other 23 cases did not preserve laryngeal function and all restored breathing and swallowing function after surgery. In the surgery group, the complication rate after surgery was 41.2% (28/68), and complication rate of patients from 70 to 75 years old was 38.6%(17/44), while patients over 75 years old was 45.8%(11/24), without significant difference(P=0.56); and the decannulation rate of the two age groups were 61.4%(27/44) and 62.5%(15/24), respectively, without significant difference(P=0.93). Conclusion It is secure and effective for elder hypopharyngeal cancer patients to choose proper surgeries according to their general conditions and the extent of tumor invasion.