Objective: To explore the effects of closed-loop target-controlled infusion (TCI) of propofol based on bispectral index (BIS) in surgery of elderly fracture patients. Methods: 80 elderly fracture patients were randomly divided into group A and group B with 40 patients in each group. The patients in group A were given propofol with BIS-based closed-loop TCI target-controlled infusion, while the patients in group B were given propofol with constant-speed infusion. The perioperative indicators and the incidence of perioperative events, as well as BIS, heart rate (HR) and mean arterial pressure (MAP) at five time point (T ₁ before anesthesia induction, T ₂ endotracheal intubation, T ₃ skin incision, T ₄ 30 minutes after operation, T ₅ at the end of operation) of patients in 2 groups were compared. Results: The propofol dosage, recovery time and the time of tracheal extubation of patients in group A were obviously lower than group B (P˂0.05). At time point T ₂ to T ₅, the BIS and MAP of patients in group A were obviously higher than group B (P˂0.05), the HR were obviously lower than group B (P˂0.05). The incidence rate of perioperative events of group A was obviously lower than group B (5.00% vs 20.00%, P˂0.05). Conclusions: BIS-based closed-loop TCI target-controlled infusion of propofol can reduce the stress level surgery of elderly fracture patients and the propofol dosage, and also can improve the safety of operation effectively.