Hyperthyroidism (referred to as hyperthyroidism) is a common and frequent disease in general surgery. Treatment includes surgery, radioactive 131I therapy and anti-thyroid medication, among which surgery is currently the most effective treatment with good control of hyperthyroidism symptoms and low recurrence rate. In recent years, as the elderly population grows, the number of elderly patients (age of onset >60 years) with hyperthyroidism is also increasing. As a special group of patients, the treatment of hyperthyroidism in the elderly has its own characteristics. Many elderly hyperthyroid patients ask us whether they can undergo surgical treatment for hyperthyroidism in the elderly. The incidence of secondary hyperthyroidism is higher in women than in men; hypermetabolic syndrome is not obvious and the incidence of proptosis is low; the thyroid gland is often not enlarged or mildly enlarged; cardiovascular system symptoms are obvious and have a high incidence, often manifesting as tachycardia and arrhythmia, leading to heart enlargement and heart failure. Digestive system symptoms are not typically manifested by hyperphagia, but anorexia and diarrhea also occur frequently. Liver compensatory function of the elderly is not as good as that of young people, and liver damage often occurs; neurological stress is reduced, manifesting as indifferent hyperthyroidism; there are many concomitant diseases, and the elderly are prone to coronary heart disease, chronic bronchitis (emphysema, pulmonary heart disease), hypertension, diabetes, and tumors. The elderly have undergone certain degeneration in terms of psychology, morphological structure and function of the organism, and are often accompanied by chronic diseases such as coronary heart disease, hypertension, chronic bronchitis and diabetes, etc. The immunity, compensatory capacity, physiological reserve capacity and resistance of the organism have decreased, and the tolerance to surgery is poor, the preoperative preparation process is complicated, and there are many postoperative complications in the near and long term. Therefore, the current treatment of hyperthyroidism in the elderly mainly adopts anti-thyroid medication and radioactive 131I therapy, while giving symptomatic support treatment for other comorbidities, and most elderly patients can achieve better results. However, surgery is necessary for elderly patients who have failed medical treatment, poor drug tolerance or combined nodules, especially those with pressure symptoms and cold nodules that cannot be excluded from cancer on nuclear scan; adequate preoperative preparation, active management of concomitant diseases, selection of appropriate anesthesia, careful intraoperative operation and close postoperative supervision and management are still safe and effective for elderly patients with hyperthyroidism. The surgical treatment is still safe and effective for elderly patients with hyperthyroidism.