Abstract: Objective: To investigate the safety and efficacy of painless gastroscopy for aged patients. Methods: One hundred and sixty elderly patients were divided into sedative group (n=160) and control group (n=101). The sedative group received propofol and midazolam intravenously in addition to routine operation. The reaction, operative duration and conscious time were compared between the two groups. The changes of blood pressure, heart rate and blood oxygen saturation (SaO₂) before and after operation were recorded and analyzed. Results: 99.4% of the patients in the sedative group and 35% in the control group did not complain of any discomfort or pain during gastroscopy (P<0.01). The incidence of cough, restlessness, nausea, vomiting and guttural discomfort in the sedative group was lower than that of the control group. The operative duration was shorter in the sedative group (4.5±1.5) min than in the control group (5.6±1.8) min (P<0.01). The recovery time of the sedative group was (1.4±1.3) min. In the process of inspection, the blood pressure and SaO₂ of the patients in the sedative group reduced slightly, but within normal limits. No serious arrhythmia or myocardial ischemia was observed. All the patients went through successfully, leaving no painful memories. Conclusions: Painless gastroscopy is safe for aged patients.