Objective: To investigate the necessity of gastrointestinal decompression for the elderly patients with colorectal cancer during perioperative period. Methods: A meta-analysis was performed on the results of 6 studies that met the inclusion criteria from 211 retrieved literatures using the Mantel-Haenszel method, and the odds ratio (OR) was calculated. Results: There were a total of 794 cases in the 6 selected studies, of whom, 407 did not use a nasogastric tube (N-NG group) and 387 received nasogastric tube placement (NG group). Compared to the NG group, the overall complications of the N-NG group decreased by 14.4% (P=0.0002); time to ?rst passage of flatus and stool of the N-NG group was shorter (P=0.004, P=0.000); the incidence of pulmonary infection, pharyngolaryngitis and fever of the N-NG group was lower by 15.85%, 15.85% and 12.02%, respectively (P=0.000, P=0.000, P=0.0006); the length of hospital stay and costs of the N-NG group were also reduced (P=0.000, P=0.000). The sensitivity analysis confirmed the reliability of the conclusions. Conclusion: Non-use of gastrointestinal decompression during perioperative period in elderly patients with colorectal cancer can not only decrease the incidence of complications and infections, and shorten the time for bowel function recovery, but also reduce hospital stay and costs.