Abstract: Objective To analyze the effect of B-ultrasound guided peripheral nerve block anesthesia in elderly patients with lower limb surgery. Methods A total of 130 elderly patients undergoing lower limb surgery were selected as study objects, and were equally divided into study group(given peripheral nerve block anesthesia under B ultrasound guidance)and conventional group(given peripheral nerve block anesthesia)according to different anesthesia methods. The relevant indexes after intervention in two groups were compared. Results The agitation score, mean arterial pressure, and heart rate of the study group were better than that in the conventional group(P<0.05); the awaking time and extubation time of the study group were significantly shorter than that of the conventional group(P<0.05); compared with the conventional group, the study group had longer sensory and motor block time(P<0.05); compared with the conventional group, the pain scores at 2, 4, and 8 hours after operation in the study group after surgery were significantly lower(P<0.05). Conclusion B-ultrasound guided peripheral nerve block anesthesia can significantly improve anesthesia efficacy in elderly patients with lower extremity surgery, and they have lighter stress response.