Perioperative neurocognitive disorder (PND) is one of the major complications in elderly surgical patients and has significant effect on their long‑term prognosis. Benzodiazepines are widely used in the perioperative period for their sedative and anxiolytic effects; however, their impact on PND in elderly patients remains controversial. This review aims to assess the effects of benzodiazepines in preoperative, intraoperative, and postoperative use, and to comprehensively analyze the relationship between the perioperative use of benzodiazepines and PND. These findings will provide clinicians with a more comprehensive guide to optimize the perioperative management of elderly patients, reduce the incidence of PND, and improve long‑term outcomes.