Purpose: This meta-analysis aimed to assess whether the age would affect the efficacy of anti-vascular endothelial growth factor (VEGF) agents in advanced non-small-cell lung cancer (NSCLC). Methods: Electronic data-bases, including PubMed, Web of Science and the Cochrane Central Register of Controlled trials were searched to identify relevant studies. Eligible studies included prospective randomized controlled trials (RCTs) evaluating therapies with or without anti-VEGF agents in elderly patients with advanced NSCLC. Hazard ratios (HRs) were used to estimate overall survival (OS) and progression-free survival (PFS). Sub-group analysis and publication bias were also evaluated. Results: Ten trials involving a total of 3,163 elderly patients with advanced NSCLC were included. The addition of anti-VEGF agents to therapies in elderly patients significantly improve PFS (HR 0.88, 95% CI: 0.88-1.00, P=0.048), but not for OS (HR 0.99, 95% CI: 0.90-1.10, P=0.91) when compared to controls. On subgroup analysis, similar results were found based on treatment line. No publication bias was detected by Begg's and Egger's tests for OS. Conclusions: Among elderly patients with advanced NSCLC, the use of anti-VEGF agents offers an improved PFS, but not for overall survival benefit. With present evidence, we are still unable to clearly set the role of anti-VEGF agents in the treatment of advanced NSCLC in this setting.