Abstract： Objective： To observe the effect of acupuncture combined with epidural anesthesia on anesthesia and circulatory function in elderly patients undergoing lower extremity fracture surgery. Methods： A total of 80 elderly patients with undergoing lower extremity fracture surgery were randomly divided into the control group and the observation group，with 40 cases in each group. The control group received epidural anesthesia， and the observation group received acupuncture anesthesia based on the treatment of the control group. The anesthetic effect，pain degree，circulatory function and anesthetic drug dosage were compared between the two groups. Results：The good-and-moderate rate of anesthesia in the observation group was 97.50%，higher than that of 82.50% in the control group(P＜0.05). At the time of skin incision(T1)，the Visual Analogue Scale(VAS) scores in the two groups were decreased when compared with those before anesthesia(T0)(P＜0.05)，and the VAS score in the observation group was lower than that in the control group(P＜0.05)；one hour after the start of the surgery(T2)，the VAS scores in both groups were increased when compared with those at T1(P＜0.05)， and the VAS score in the control group was higher(P＜0.05)； at the end of surgery(T3)， the VAS scores in the two groups were decreased when compared with those at T2(P＜0.05)， there being no significant difference between the two groups(P＞ 0.05). At T1 and T2， the heart rate(HR)， diastolic blood pressure(DBP)， systolic blood pressure(SBP) and mean arterial pressure(MAP) in the two groups were increased when compared with those at T0(P＜0.05)， and the increase of HR，DBP，SBP and MAP in the observation group were lower than those in the control group(P＜0.05)；at T3，the HR，DBP，SBP and MAP in the two groups were decreased when compared with those in the same group at T1 and T2(P＜0.05)， but there being no significant difference in the comparison of HR，DBP，SBP and MAP in the observation group when compared with those in the same group at T0(P＞0.05). The average dosage per hour and average dosage per case of epidural anesthesia in the observation group were lower than those in the control group(P＜0.05). Conclusion： The therapy of acupuncture and epidural anesthesia for elderly patients undergoing lower extremity fracture surgery can improve the anesthetic effect， reduce the intraoperative pain， stabilize the circulatory function， and reduce the amount of anesthetic drugs.