The morbidity of the elders with chronic diseases increased obviously. Tumor - related deaths have compromised to 28. 6% of all - cause deaths for elder population. Patients over 65 years old have occupied a ratio about 25% - 33% of all the hospitalized patients in department of surgery. Meanwhile surgery-related complications mortality re-admission rate and commercial burden all increased significantly. For this reason choosing adequate tools aiming at the aged patients for the nutritional screening and evaluation before operation and predicting surgery - related risks and outcomes will contribute crucially to reduce the morbidity of post-operative complications and mortality while enhance prehabilitation efficiently further save medical resources and improve the efficiency of society. This article introduced the circumstance of graying society in China and the evaluations of nutrition tools which aim at elderly patients in Department of Digestive Surgery for prediction perioperative risks and outcomes. Several single -centered researches have implicated that geriatric nutritional risk index GNRI played a positive role in predicting the perioperative risks and outcomes of elderly patients with colorectal cancer or hepatic cell carcinoma. To be specific GNRI may actually be beneficial to evaluate pre - operatively nutritional status and predict the risks of severely surgery - related complications overall survival and recurrence-free or progression - free survival. Five meta - analyses studies searched at present elucidated a common conclusion in consistent with the single-centered researches mentioned above. However the four articles all emphasized that the original researches included in analysis were mostly retrospective designed which means limited sample sizes and high heterogeneity in integrated data. Therefore it still needs efforts of our fellows in surgery to conduct multi-centered prospective well-designed clinical study to evaluate GNRI tools objectively.