OBJECTIVE: To explore the early and late operation results and risk factors of elderly acute type-A aortic dissection. METHODS: The regression analysis was conducted on the data of patients diagnosed with acute type-A aortic dissection in our hospital from January 2018 to January 2020, and a total of 98 patients aged over 70 years were included in the study. The patients were listed into the early operation group (a total of 51 patients operated within 3 days after admission) and the late operation group (a total of 47 patients operated within 10 days after admission) according to the time of operation. The operation results, postoperative complications and death were compared between the two groups, and the prognosis risk factors were analyzed through Logistic multi-factor regression. RESULTS: The operative time, aortic obstruction time and extracorporeal circulation time of the late operation group were all higher than those in the early operation group (p <0.05). The postoperative complications and mortality in the late operation group (12.77%) were higher than those in the early operation group (3.92%) (p < 0.05). The Logistic multi-factor regression showed that late operation (p=0.005, OR=4.213, 95% CI=1.567~11.201), postoperative acute renal insufficiency (p=0.028, OR=3.281, 95% CI=0.937~10.283), and postoperative pulmonary infection (p=0.033, OR=1.421, 95% CI=0.417~8.329) were risk factors affecting postoperative mortality (p <0.05). CONCLUSION: The early operation can effectively reduce the postoperative complications of elderly acute type-A aortic dissection, so early operation should be performed according to the conditions of patients and hospital.