Objective: To explore the application value of sevoflurane + propofol in elderly patients undergoing cholecystectomy. Methods: A total of 121 elderly patients undergoing cholecystectomy in our hospital from February 2017 to March 2020 were enrolled. Among them, 58 patients were assigned to Group A given, anesthesia with sevoflurane during operation, and 63 patients to Group B who were given anesthesia with sevoflurane + propofol during the operation. The Mini-Mental State Examination (MMSE) was adopted to evaluate the cognitive function of the two groups at 1 hour (T1), 3 hours (T2) and 12 hours (T3) after operation, and enzyme-linked immuno-sorbent assay (ELISA) was used to determine inflammatory factors. The incidence of postoperative adverse reactions was compared between the two groups. Results: The heart rate (HR) of patients at T2 was significantly lower than that at T1 and T3, and their HR at T3 was lower than that at T1 (P<0.05). There were differences in systolic blood pressure (SBP) and diastolic blood pressure (DBP) at different time points in each group (both P<0.001). The mean artistic pressure (MAP) of patients at T2 was significantly lower than that at T1 and T3, and their MAP at T3 was lower than that at T1 (P<0.05). Additionally, oxygen saturation (SpO(2)) of patients at T2 was also significantly lower than that at T1 and T3, and their SpO(2) at T3 was lower than that at T1 (P<0.05). Moreover, Group B showed significantly lower levels of serum inflammatory factors than Group A at T2 and T3 (P<0.05), and also got greatly lower Observer Assessment of Sedation (OAA/S) scores than Group A (P<0.05). Conclusion: Sevoflurane + propofol can effectively improve the recovery quality and cognitive function and reduce inflammation after cholecystectomy in the elderly, so it is worthy of clinical promotion.