Abstract: Objective To learn more about the application effect of fast-track surgery (FTS) on the prognosis of elderly patients with gastric cancer undergoing radical surgery. Methods A total of 120 patients with gastric cancer treated in Fuyang District Hospital of Traditional Chinese Medicine from March, 2014 to December, 2016 were randomly divided into study group and control group, with 60 cases in each group. Patients in the control group were given general nursing care and anti-inflammatory, anti-bacterial, analgesic, rehydration and other symptomatic supportive care. Patients in the study group were given the FTS concept care on the basis of the control group's treatment. The operation time, intraoperative blood loss, hospital stay, hospitalization costs, postoperative prognosis and related complications were compared between the two groups. Results The operation time, blood loss and the number of lymph node dissection in the two groups had no significant difference (P>0.05); The anesthesia time and intraoperative fluid infusion in the study group were significantly lower than those in the control group (P<0.05); The eating time, bed ambulation time, hospital stay, anal exhaust defecation time and hospitalization costs in the study group were significantly lower than those in the control group (P<0.05); There was no significant difference in the incidence of hemorrhage, gastrointestinal fistula and other complications between the two groups (P>0.05), but the incidence of postoperative infection and pulmonary complications in study group was significantly lower than that in control group (P<0.05). Conclusion FTS for the treatment of elderly patients with gastric cancer is affirmative, which is more effective in promoting postoperative recovery, improving patient prognosis, reducing hospital costs, and improving the quality of life of patients, thus worthy of clinical promotion. However, there is still a need to combine patients with the actual use of individualized and generalized principles combined.