Objective To evaluate the effects of conscious sedation analgesia during superficial bladder tumor resection for elderly patients. Methods Forty elderly patients who needed 2 μm laser resection for bladder tumors were treated with target controlled infusion (TCI) remifentanil and propofol. The initial target concentration of remifentanil was 2.5 ng/mL and that of propofol was 1 μg/mL. The target concentration of those two agents was adjusted until loss of painfulness to the operative stimulus. The MAP, HR, SpO2, RR and PetCO2, BIS and scores by OAA/S were compared between pre-and post-surgery at different time points (time before anesthesia, T0; time before analgesia, T1; time when the resection began, T2; 5 minutes after the resection began, T3;10 minutes after the resection began, T4; 15 minutes after the resection began, T5; the end of operation, T6;5 minutes after operation). Results All patients lived through the surgery under a conscious sedation. After the anesthesia, blood pressure, heart rate and breathing rate were declined, while oxygen saturation was unchanged. Conclusion TCI with remifentanil and propofol provides better hemodynamic stability, satisfactory sedation analgesia and faster recovery of surgery.