Objective To investigate the effect of epidural anesthesia combined with general anesthesia on hemodynamics and stress status in elderly patients with hypertension. Methods One hundred and eighteen elderly patients with hypertension treated by laparoscopic cholecystectomy from January 2014 to January 2017 were selected, and were randomly divided into group A and group B, fifty-nine cases in each. General anesthesia was used in group A, while epidural anesthesia combined with general anesthesia was used in group B. The systolic blood pressure (SBP), diastolic blood pressure (DBP), heart rate (HR) and oxygen saturation (SpO₂) before anesthesia (T0), after intubation (T1), 10min after pneumoperitoneum (T2), and before extubation (T3) were compared between the two groups. The levels of growth hormone (GH), prolactin (PRL) and cortisol (Cor) in T0, T1, T2 and T3 were compared between the two groups. The breathing recovery time, awake time and extubation time after operation were compared between the two groups. The incidence of emergence delirium were compared between the two groups. Results The SBP, DBP and HR of the two groups in T1, T2 and T3 were significantly higher than those in T0. The SBP and DBP of group B in T1 T2 and T3 were significantly lower than those of group A, while the HR was significantly higher than that of group A. The levels of GH, PRL and Cor of group B in T1, T2 and T3 were significantly lower than those of group A. The breathing recovery time, awake time and extubation time after operation of group B were significantly less than those of group A . The incidence rate of emergence delirium of group B was 6.78%, which was significantly lower than that of group A. Conclusion Epidural anesthesia combined with general anesthesia is more conducive to maintaining the stability of hemodynamics in elderly patients with hypertension. It can reduce the stress response and shortening the postoperative recovery time.