Purpose of Review <p>With an increasing number of elderly patients undergoing abdominal tumor surgeries, there is a pressing need for safer and more effective anesthesia management strategies. Esketamine shows promise as an adjunct in general anesthesia for these patients due to its unique clinical effects. This review explores the pharmacological profile, mechanism of action, and current clinical applications of esketamine in managing anesthesia for elderly patients, as well as its potential adverse effects.</p> Recent Findings <p>Esketamine has been shown to reduce short-term postoperative anxiety and depression, relieve postoperative pain and stress, and accelerate postoperative recovery. In addition, newer studies are exploring the use of esketamine for treatment-resistant depression.</p> Summary <p>Esketamine offers rapid onset, fast metabolism, and fewer side effects, which promote faster recovery in elderly patients undergoing abdominal tumor surgery. However, its exact mechanisms, optimal dosing, and potential side effects require further study.</p>