This study aimed to observe the effect of propofol-based total intravenous anaesthesia (TIVA) on postoperative cognitive function and sleep quality in elderly patients. From August 2019 to August 2020, 130 cases of elderly patients who underwent abdominal surgery in The Third Hospital of Hebei Medical University were enrolled in this study. All participants were randomly divided into TIVA group (n=65, receiving propofol-based TIVA) and control group (n=65, receiving inhaled of sevoflurane anaesthesia). Intra-operative indicators were recorded in both groups. The cognitive function, sleep quality, urine melatonin sulphate, free cortisol, S-100 β protein and interleukin-6 (IL-6) levels were compared at different times. On 1, 3, 7 and 15days after operation, the cognitive function of the TIVA group was better than that of the control group, with statistically significance (P<.05, respectively). On the day of surgery, the two groups had similar sleep quality. The sleep quality of the TIVA group was better than that of the control group on 1, 3 and 7days after surgery (P<.05, respectively). On the day of surgery, the levels of melatonin, cortisol, S-100β protein and IL-6 in the two groups were equivalent (P>.05). On 1, 3, 7 and 15days after surgery, cortisol and IL-6 in the TIVA group were lower than those of the control group, and melatonin was higher than that of the control group (P<.05, respectively). On 1, 3 and 7days after operation, the S-100 β protein in the TIVA group was lower than that in the control group (P<.05, respectively). Propofol-based TIVA has little effect on the cognitive function and sleep quality of elderly patients after surgery, and it is worthy of clinical application.