Objective To investigate the clinical efficacy and toxicity of bevacizumab combined with chemotherapy in elderly patients with gastrointestinal neoplasms.Methods A total of 64 elderly patients with gastrointestinal neoplasms were selected.The clinical data of patients treated with chemotherapy or chemotherapy plus bevacizumab were analyzed.Patients were randomly divided into the observation group and the control group (n=32,each).The observation group was treated with bevacizumab (7.5 mg/kg) in combination with XELOX (OXA+Xeloda),and the control group was treated with XELOX only (21 weeks as a cycle).The clinical efficacy and toxicity of bevacizumab were evaluated according to WHO short-term efficacy standards and standards of anticancer drugs in acute or subacute adverse reactions.Results In observation group,complete remission was found in 4 cases,partial response in 18 cases,stable disease in 6 cases,progressive disease in 4 cases,and the total efficiency was 68.8％.In control group,partial response was found in 14 cases,stable disease in 11 cases,progressive disease in 7 cases,and the total efficiency was 43.8％.The incidences of leucopenia,hemoglobin desaturation and gastrointestinal reactions were lower and the incidence of thrombocytopenia was higher in observation group than in control group,which had no significant differences between the 2 groups.Phase Ⅳ toxicity was not found in observation group.Conclusions Bevacizumab combined with chemotherapy is safe and effective for elderly patients with gastrointestinal neoplasms.Most patients can tolerate the side effects.It is worth promoting in clinical medicine.