Abstract: Objective To compare the effect of fast-track surgery and conventional perioperative treatment on the rehabilitation effect, immune function and inflammatory stress response in elderly patients with colorectal cancer. Methods Eighty patients undergoing surgery for gastrointestinal surgery in Henan Cancer Hospital from March, 2014 to March, 2016 were selected for clinical study. A prospective randomized study was conducted to divide patients into group FTS (perioperative fast rehabilitation surgery) and routine group (routine perioperative treatment) in 40 cases. The effects of the 2 groups were compared, the immune function and the inflammatory stress before and after the operation were compared. Results The levels of serum IL-6, IL-8, TNF-α, IL-1β on D1, D3 and D7 after the operation in FTS group of beta levels were lower than those in the normal group (P<0.05); the levels of serum IgG, IgA, IgM, CD3⁺ and CD4⁺ on D3 and D7 after the operation in FTS group were higher than those in the normal group (P<0.05), by contrast, CD8⁺ level was lower (P<0.05). The time to first flatus, first oral feeding and first defecation, duration of hospital stays and the incidence of operative complications in the FTS group were all lower than those in the conventional perioperative treatment group (P<0.05). Conclusion The perioperative fast-track surgery care for the patients with colon cancer is helpful to the recovery of immune function and reduce the inflammatory response.