Abstract: The purpose of this study was to evaluate the outcome of thoracoscopy vs conventional thoracotomy in the treatment of elderly non-small cell lung cancer (NSCLC) . A total of 169 elderly NSCLS patients in our hospital were enrolled to be evaluated and compared for the stress response and recurrence rate related to thoracoscopy and conventional thoracotomy. The findings showed that thoracoscopy was associated with less time, blood loss, duration of postoperative drainage and shorter hospital stay ( P<0.05) , and also with significant improvement in stress response indicators and postoperative complications ( P<0.05) . In conclusion, minimally invasive thoracoscopic surgery may lead to reductions in intraoperative injury and postoperative stress response for elderly NSCLC patients.