Abstract: OBJECTIVE To compare and analyze the effects of general anesthesia via laryngeal mask airway and endotracheal intubation on the postoperative pulmonary infections in the elderly patients, so as to provide a research basis for the prevention of postoperative infections after general anesthesia. METHODS 200 cases of elderly patients treated with surgeries under general anesthesia from May 2016 to Aug. 2017 were selected as the research subjects. The patients were divided into the laryngeal mask airway group and the endotracheal intubation group according to the way of establishment of artificial airway during anesthesia, with 100 patients in each group. The lowest oxygen saturation (SpO₂) during operation, the highest arterial carbon dioxide tension end-tidal carbon dioxide tension (PetCO₂), the peripheral white blood cell count (△WBC), the peripheral neutrophil percentage (△NEU%) before the operation and 1 day after the operation of the patients in the two groups were observed and compared. The occurrence of adverse events and the pulmonary infections of the patients in the two groups were observed and compared. RESULTS The time of postoperative recovery of the patients in the laryngeal mask airway group was (0.38±0.17) h, which was significantly shorter than (1.21±0.34) h in the endotracheal intubation group (P<0.05). The △WBC, △NEU%, the time of postoperative food taking, the time of out-of-bed activity, the time of postoperative hospitalization of the patients of the patients in the laryngeal mask airway group were significantly shorter than those in the endotracheal intubation group (P<0.05). The incidences of the astrointestinal reactions, throat discomforts and hoarseness of the patients in the laryngeal mask airway group were significantly lower than those in the endotracheal intubation group (P<0.05). The incidences of the postoperative pulmonary infections and the occurrence ratios of fever, pulmonary rales, cough and wheezing of the patients in the laryngeal mask airway group were significantly lower than those in the endotracheal intubation group (P<0.05). CONCLUSION Compared with the application of endotracheal intubation, the application of laryngeal mask as artificial airway in the elderly patients treated with surgeries under general anesthesia can promote the patients' recovery and rehabilitation, reduce the inhibition of immune function after surgery, decrease the incidences of postoperative pulmonary infections and the pulmonary infection symptoms, in addition to ensuring the stability of the blood oxygen levels during the operations.