There is a high risk of postoperative complication of ulcer perforation in senile patients, and there is no effective predictive method previously. Nutritional risk assessment improves clinical outcome and reduces the incidence of complication by receiving nutritional support treatment for patients at risk of nutrition. Aims: To investigate the predictive value of nutritional risk assessment for postoperative complication in elderly patients with gastroduodenal ulcer perforation. Methods: A total of 100 patients with perforation of gastroduodenal ulcer from January 2015 to December 2017 at Heyuan People's Hospital Affiliated to Jinan University were enrolled. NRS-2002 score and SGA score were used for nutritional risk assessment. The occurrence of postoperative complication was recorded, and risk factors of postoperative complication were analyzed by multivariate Logistic regression analysis. Results: NRS-2002 score showed that no nutritional risk in 37 patients, 63 patients with nutritional risk. SGA score showed that no malnutrition was found in 41 patients, moderate malnutrition in 32 patients, and severe malnutrition in 27 patients. There was no significant difference in the proportion of no malnutrition/nutritional risk between the two groups (P>0.05). Different degrees of complication occurred in 21 patients. NRS-2002 score and SGA score were correlated with the incidence of serious complication and infectious complication (P<0.05). Multivariate Logistic regression analysis showed that NRS-2002 score and SGA score were independent risk factors for postoperative complication of gastroduodenal ulcer perforation (P<0.05). Conclusions: NRS-2002 score and SGA score can be used to assess malnutrition in elderly patients with perforation of gastroduodenal ulcer. NRS-2002 score, SGA score are closely related to postoperative complication, and can be used to predict the risk of postoperative complication.