Abstract: Objective To compare the safety and clinical effectiveness of Da Vinci robotic versus laparoscopic surgery for elderly patients with colon cancer. Methods Clinical data about 129 patients with age over 70 years (average age of 78.0±4.9 years) who underwent Da Vinci robotic radical colectomy (n=43) or laparoscopic radical colectomy (n=86) in department of general surgery, Chinese PLA General Hospital from January 2013 to January 2015 were retrospectively analyzed. Perioperative indicators and clinical outcomes were compared between the two groups. Results There was no significant difference in baseline data between two groups, such as age, sex, body mass index (BMI), tumor location and so on (all P＞ 0.05). Compared with laparoscopic group, robotic group had longer operating time (330.6±142.5) min vs (214.5±42.73) min, P=0.034 and higher hospitalization costs(96.3±16.1) thousand yuan vs (63.0±17.7) thousand yuan, P=0.000. No significant difference was found in the number of retrieved lymph nodes, time to remove the urinary catheter and abdominal catheter, postoperative complications, time to flatus, time to oral intake, length of hospital stay, the overall and disease-free survival rates at 3 years after operation between two groups (all P＞ 0.05). Conclusion In patients aged over 70 years, robotic colon surgery shows similar safety and clinical effectiveness to those obtained by laparoscopy, but longer operative time and higher costs.