【Abstract】〓Objective〓To investigate the clinical effect of low pressure pneumoperitoneum laparoscopic technology in the treatment of acute appendicitis in the elderly. Methods〓104 elderly patients with acute appendicitis were assigned to low pressure pneumoperitoneum laparoscopic technology(low pressure group) and the standard pressure(standard pressure group) pneumoperitoneum laparoscopic technology. The clinical effect was analyzed in two groups. And the operative time, blood loss, complications, postoperative hospital stay, PaCO2 and BNP were considered between two groups. Results〓A total of 52 patients received low pressure gas laparoscopic technology and another 52 patients received the regular pressure gas laparoscopic technology. All patients were successfully received laparoscopic surgery. The operative time was 36.6±10.3 min in low pressure group, and 33.7±11.2 min in standard pressure group (P=0.17). Blood loss in low pressure group group (40.1±5.3 ml) was more than that in standanrd pressure group (38.5±4.3 ml), but without statistics differences (P=0.09). There were also no differences in complications, with two cases in low pressure group group, and 8 cases in standard pressure group (P=0.046). However, there are significant differences in postoperative hospital stay (P<0.01), PaCO2 (P=0.016) and BNP (P=0.01) between two groups. Conclusion〓Low pressure pneumoperitoneum laparoscopic appendectomy in the elderly is feasible and safe, and with rapid recovery and less influences in respiratory and circulation system.