In recent years, more elderly patients with gastrointestinal cancers have been undergoing surgery. As one of main postoperative complications, postoperative delirium (POD) is harmful and difficult to prevent and treat. Prevention, diagnosis and treatment to POD properly and ptomptly can promote the patient's overall recovery However, health care providers still have many problems for POD to face in elderly with gastrointestinal cancers during the clinical care. In this paper, Etiology damages, prevention, diagnosis and treatment of POD in elderly with gastrointestinal cancer were reviewed, and the prospect of POD was also discussed.