The literatures have demonstrated that Teach-back method is an effective communication tool to understand health education, especially in the elderly patients. However, there is limited research of Teach-back method in preoperative education for outpatient surgical patients. This study was conducted to investigate the effects of the Teach-back method on preoperative anxiety and surgical cooperation in elderly patients undergoing outpatient ophthalmology surgery. One hundred sixteen elderly patients who underwent outpatient ophthalmology surgery were selected as the research objects. They were divided into the observation group (58 cases) and the control group (58 cases). The Teach-back preoperative education was adopted in the observation group and the standard preoperative education method was adopted in the control group. The degree of anxiety, surgical cooperation, and awareness of health knowledge were compared between the 2 groups, and the variations of blood pressure and heart rate, as well as the highest values of intraoperative blood pressure and heart rate before and after method, were recorded and compared. The preoperative systolic blood pressure in the observation group was significantly lower than that in the control group. The intraoperative (the highest value) heart rate, systolic blood pressure, and diastolic blood pressure in the observation group were lower than those in the control group, and the differences were statistically significant (P < .05). After intervention, the anxiety score and information demand score of the observation group were lower than those of the control group, and the differences were statistically significant (P < .05). The degree of surgery cooperation and awareness of perioperative health knowledge in the observation group were all higher than those in the control group; the differences were statistically significant (P < .05). The Teach-back method could relieve the preoperative anxiety of the patients, improve the quality of patients surgery cooperation, and facilitate the awareness of health knowledge. Moreover, it could effectively improve the intraoperative stress response of the elderly patients and reduce the large fluctuations of blood pressure and heart rate.