Objective To study the safety and efficacy of target-controlled infusion (TCI) sedation with low dose ketamine and propofol during rigid cystoscopy in elderly male patients. Methods Forty-five elderly male patients with I - III grade of the American Society of Anesthesiologists (ASA)rigid cystoscopy examination were divided into 3 groups randomly: group A, 2% lydocaine gel was filled in urethra, n=15; group B, 2% lydocaine gel filled with propofol TCI sedation, n=15; group C, 2% lydocaine gel filled with combined ketamine and propofol TCI sedation, n= 15. The mean artery pressure (MAP), heart rate(HR), pulse oxygen saturation (SPO2)were measured at 5 time points; preoperation, during local anesthesia, inserting the scope, during testing and the end of testing. The concentration of effect room, wake time when alertness and calm grading (OAA/S)was 3 scores in B and C groups and visual analogue scale( VAS) score of pain after operation were detected. Results The MAP and HR at the time point of inserting the scope in group A had significant difference,compared with preoperation(P0. 05) . In group A, 10 cases pain VAS score were light pain, 4 moderate and 1 severe. In group B and C,no pain and no memory of the operation were reported. Conclusions TCI sedation with low dose of ketamine and propofol in elderly male patients under rigid cystoscope has good effects on sedation, analgesia and anterograde amnesia. The hemodynamics is stable and wake time is short.