Objective To observe the pemetrexed treatment of advanced non-small cell lung cancer and toxicity, corresponding to explore nursing. Methods 32 cases of elderly patients with advanced non-small cell lung cancer patients were infused pemetrexed in order to evaluate efficacy, toxicity, and implement appropriate care measures. Results 32 patients with advanced non-small cell lung cancer patients with pemetrexed treatment, complete remission (CR) 2 patients and partial remission (PR) 17 cases, stable (SD) 6 cases and progress (PD)7 cases. Toxicity occurs mainly in bone marrow suppression, gastrointestinal reactions, allergic reactions and drug extravasation and so on. 2 cases Ⅱ myelosuppression, 1 Ⅳ myelosuppression; Ⅱ nausea and vomiting in 19 cases, 5 cases of mild constipation; 2 patients had severe skin itching. The effective symptomatic treatment and active care measures have been eased. Conclusion Pemetrexed treatment of advanced non-small cell lung cancer patients, master the correct method of administration, toxicity of timely symptomatic treatment and care interventions can improve the quality of life of patients.