Population aging is a global challenge for the medical community, and anesthesia management in the elderly is becoming an increasingly important area of research and practice. This review paper explores the specifics of general anesthesia in the elderly, with an emphasis on key factors that influence the safety and effectiveness of anesthesia in this population. Elderly patients often have more comorbidities and medications, requiring a thorough assessment before anesthesia. In addition, physiological changes associated with aging, such as a decrease in organ function, a decrease in muscle mass, and changes in the pharmacokinetics of drugs, affect the pharmacodynamics of anesthetics. Therefore, precise adjustment of doses and selection of anesthetics is extremely important. Cognitive disorders, such as dementia, are also common in the elderly population and require special attention. It is important to perform a detailed evaluation of cognitive function before anesthesia to identify potential risks and adjust perioperative strategies. Pain control and antiemetic prophylaxis play a key role in the postoperative management of elderly patients. The anesthetic plan should include strategies to minimize postoperative complications and improve the patient's quality of life. Additionally, proper fluid and electrolyte management during surgery plays a key role in maintaining hemodynamic stability and preventing complications. It is important to point out that an individualized approach to each elderly patient is the basis of safe anesthesia. The teamwork of medical professionals, including anesthesiologists, geriatricians, and nurses, plays a key role in ensuring the best care for the elderly during surgical procedures. General anesthesia in the elderly requires special care and adaptation to ensure safety and efficacy. Understanding the physiologic changes, comorbidities, and specific needs of older patients is critical to successful anesthesia management in this population. Advances in medical research and practice, along with careful assessment and teamwork, help improve the quality of care for the elderly during surgery.