Objective To observe the preventive effect of recent postoperative cognitive dysfunction（POCD） on the aged with traditional Chinese medicine（TCM） differential treatment. Methods Forty six elderly patients undergoing elective total hip replacement surgery were randomly allocated into two groups（n=23） according to the treatment：observation group and control group. The mini-mental state examination（MMSE） scores of all the patients were recorded one day before surgery，one day and seven days after surgery. Results The MMSE scores of the control group on the first day and the seventh day after surgery were both lower than that before surgery （P＜0. 05）， but the difference of MMSE scores were not statistically significant in the observation group （P＞0. 05）. The incidence of cognitive impairment on the first day after surgery in the observation group（9%） was lower than that in the observation group（35%）（P<0. 05）. The difference of the incidence of cognitive impairment on the seventh day after surgery was not statistically significant between the two groups（P＞0. 05）. Conclusion The recent POCD can be prevented by the TCM differential treatment on the aged people before hip replacement surgery.