〔Abstract〕 Objective To compare the effects of intraspinal anesthesia and general anesthesia on the incidence of lower extremity deep venous thrombosis (LDVT) in elderly patients with lower extremity fracture. Methods 90 elderly patients with lower extremity fracture who received surgical treatment in Yongcheng People's Hospital from January 2020 to January 2022 were selected and divided into a control group (general anesthesia) and an observation group (intraspinal anesthesia) according to random number table, 45 cases in each group. Operation status, postoperative recovery status, anesthesia status, intraoperative vital signs, and motor function status 48 h after surgery were compared between the two groups, and the incidence of postoperative LDVT and anesthesia complications were analyzed. Results The operation time, intraoperative blood loss, postoperative time of bedside activity and hospital stay in the observation group were all less than those in a control group, and the differences were statistically significant (P < 0.05). The effective time of anesthesia, postoperative eye opening time, speech statement recovery time and intraoperative anesthetic drug dosage in the observation group were all lower than those in a control group, and the differences were statistically significant (P < 0.05). The heart rate and mean arterial pressure of the observation group at 10 min after anesthesia (T1), immediately after surgery (T2) were lower than those of the control group, and the differences were statistically significant (P < 0.05). The grading of motor function 48 h after operation in the observation group was better than that in the control group, and the differences were statistically significant (Z = 2.183, P < 0.05). The incidence of postoperative LDVT and the total incidence of anesthesia adverse reactions in observation group were lower than those in control group, and the difference was statistically significant (P < 0.05). Conclusion Compared with general anesthesia, intraspinal anesthesia can effectively reduce the risk of postoperative LDVT in elderly patients with lower extremity fracture.