Elderly cholecystitis can not tolerate surgery needs to be conservative treatment, mainly including fasting, fluid replacement, nutritional support, anti-infection, pain relief and other symptomatic treatment, when the effect of conservative treatment is not good, need to carry out bile puncture drainage. Conservative treatment for cholecystitis includes fasting, fluid replacement, vitamin supplementation, and nutritional support. Anti-infective drugs are commonly used piperacillin/tazobactam, ampicillin/sulbactam, etc., and antispasmodic and analgesic (e.g., aminoglutethimide) and anti-inflammatory and choleretic drugs (e.g., anti-inflammatory and choleretic tablets) are also given. If the symptoms continue to be unrelieved or gradually worsened by conservative treatment, patients need to undergo ultrasound-guided percutaneous transhepatic cholecystectomy to drain the bile silted up in the gallbladder, reduce the pressure of the gallbladder, and alleviate the clinical symptoms. For elderly cholecystitis patients, we should pay attention to monitoring the changes of the condition, and when the effect of conservative treatment is not good, we should strive for surgery as much as possible to avoid delaying the condition.