〔Abstract〕Objective To investigate the effects of perioperative treatment based on enhanced recovery after surgery (ERAS) concept in elderly patients with acute abdomen. Methods 60 elderly patients with acute abdomen treated in Chaozhou Central Hospital from January 2019 to December 2020 were randomly divided into observation group and control group by random number table method. The patients in the control group were given routine perioperative treatment scheme, and the patients in the observation group were given perioperative treatment scheme based on EARS concept. The postoperative recovery of the two groups were compared postoperative complications and nutrition. Results Compared with the control group, the first postoperative exhaust time, first defecation time and hospital stay in the observation group were significantly shorter, and the differences were statistically significant (P < 0.05); The incidence of complications in the observation group was significantly lower (P < 0.05); The levels of prealbumin and serum albumin in the observation group were significantly higher (P < 0.05). Conclusion The perioperative treatment scheme based on EARS can effectively improve the prognosis, reduce the probability of complications and improve the nutritional status of elderly patients with acute abdomen.