Objective: To investigate the effect of esketamine combined with propofol on hemodynamics and postoperative recovery quality in patients of different ages undergoing hysteroscopy. Methods: A total of 120 patients who underwent hysteroscopy at Anyuan County People"s Hospital from January to December 2024 were selected. According to age, they were divided into group A (18-30 years old), group B (31-40 years old), and group C (41-50 years old), with 40 cases in each group. All patients were anesthetized with esketamine and propofol. The three groups were compared on hemodynamics [heart rate (HR) and mean arterial pressure (MAP)], clinical recovery score (CRS), and adverse reactions. Results: At T0, there was no statistically significant difference in MAP and HR among the three groups (P>0.05). There were few fluctuations in MAP and HR in group A at T1, T2, and T3. There were statistically significant differences compared to group B and group C (P<0.05). CRS scores of group A were higher than those of group B and group C at 30 min and 2 h after surgery (P<0.05). The incidence of postoperative adverse reactions was lower in group A than in group B and group C, but there was no significant difference among the groups (P>0.05). Conclusion: There are differences in hemodynamics and postoperative recovery quality among patients of different ages who receive hysteroscopy under anesthesia with esketamine and propofol. Younger patients have more stable hemodynamics, faster postoperative recovery, and fewer adverse reactions.