Lack of exercise, or taking multiple drugs for chronic diseases are important reasons for constipation in the elderly, which makes constipation a common and frequent disease in elderly patients, but the irrational use of clinical anthraquinone-containing drugs (such as rhubarb, aloe vera, senna, etc.) often leads to the occurrence of colonic melanosis, and the older the age, the higher the incidence, and is associated with constipation and long-term application of anthraquinone-based laxatives. Recent studies have found that: the disease is closely related to intestinal tumors and intestinal polyps, and it has also been proposed that: the evolution of colonic melanosis – adenomatous polyps – colon cancer deserves high clinical attention. Therefore, the selection of reasonable medication is the key to treat constipation patients. Chinese medicine has been used to treat constipation for thousands of years, and in recent years, the number of reports on the treatment of constipation with Chinese herbal medicine has gradually increased and has been confirmed by evidence-based medical research. Chinese medicine is safe and effective in the treatment of functional constipation, and can improve the clinical symptoms of constipated patients, with obvious advantages in overall efficacy. Constipation belongs to the category of “posterior discomfort”, “spleen contraction” and “Yang knot” in Chinese medicine, and its pathogenesis is the malfunction of large intestine conduction. It is related to the dysfunction of spleen, stomach, liver, kidney, lung and other internal organs. The pathology can be summarized as cold, heat, deficiency and actual. The actual constipation is caused by the stagnation of evil in the stomach and intestines and congestion, so the main purpose is to eliminate the evil, and give the method of diarrhea, heat, warming and dispersal, and the method of conduction, so that the evil can be removed and the stool can be passed; the deficiency constipation is caused by the loss of intestinal nourishment and the inability to push, so the first priority is to support the righteousness, and give the method of benefitting Qi, warming Yang, nourishing Yin and nourishing Blood, so that the righteousness can pass. According to the guideline: if the elderly patient has fecal impaction, the first step should be to remove the embedded feces. Volumetric laxatives (e.g. wheat bran, oxytocin, etc.) and osmotic laxatives (e.g. lactulose, polydiethanol, etc.) are preferred for laxatives, and prokinetic drugs (e.g. itopride, mosapride, etc.) are used as appropriate. For patients with severe constipation, stimulant laxatives (such as Bisacodyl) can also be applied in moderation for a short period of time. Of course, lifestyle changes such as increasing physical activity, supplying more coarse fiber foods, drinking more water, eating more gas-producing foods, and abstaining from alcohol, tobacco, and spicy foods are also beneficial for constipation treatment. Elderly patients with constipation need individualized treatment, the main purpose of treatment is to relieve symptoms and restore function. The Chinese medicine’s diagnosis and treatment is the embodiment of individualized treatment. Therefore, for elderly patients with constipation, perfecting colonoscopy, choosing gastrointestinal motility drugs and bulking agents; combining herbal tonics on the basis of evidence-based treatment may be a good choice for patients.