Objective To investigate the effects of ultrasound ⁃ guided stellate ganglion block（SGB）on stress response and early recovery quality of elderly patients undergoing robot⁃assisted laparoscopic radical prostatec⁃ tomy. Methods A total of 116 elderly patients scheduled for RALRP were selected and randomly divided into study group（group S）and control group（group C）. Group S received ultrasound⁃guided SGB before induction of anesthe⁃ sia，and group C was treated with normal saline in the same way. The heart rate（HR）and mean arterial pressure （MAP）were recorded and compared between the two groups at the time points of before anesthesia induction（T0）， immediately after tracheal intubation（T1），1 min（T2），10 min（T3），20 min（T4）after pneumoperitoneum and at the end of surgery（T5）. The concentration of serum cortisol（Cor），epinephrine（E）and norepinephrine（NE）were measured and compared as well at T0，T2，T4 and 2 h after surgery（T6）. The NRS pain scores，the consumption of sufentanil within 48 h after surgery and the（MMSE）scores on preoperative day（D0）and day 1（D1），day 3（D3）， day 5（D5）after surgery were recorded. The two groups were compared in terms of the NRS pain scores after surgery， consumed amount of sufentanil，scores of Mini ⁃mental State Examination（MMSE），early recovery index and inci⁃ dence of adverse reactions. Results Compared with group C，HR and MAP in group S were significantly decreased at T1 and T2（P < 0.05）. Group S presented remarkably lower concentrations of plasma Cor at T2，T4 and T6；and lower concentrations of plasma E and NE at T2 and T4（P < 0.05）. No statistical difference was found in the NRS scores， the consumption of sufentanil after the operation and MMSE scores between the two groups（P > 0.05）. Group S showed significantly shorter recovery time of bowel sounds and the first anal exhaust time and lower incidence of adverse reactions compared with group C. Conclusion Ultrasound⁃guided SGB can inhibit the stress response，reduce the incidence of adverse reactions and accelerate the recovery of intestinal function in elderly patients undergoing RALRP.