Should I get a transmission flush on my 2001 Honda Accord DX with 165,000 miles on it?

Well it's more like should I buy my friend's 2001 Honda Accord DX with 165,000 miles on it? He told me that there's nothing wrong with the transmission, but since the car is old that I might need to flush out the transmission.

NO NO NO. Do not flush that trans. Most places that offer trans flush services won't do it on a trans with that many miles on it. If there's no problem with that trans now, there will be shortly after a flush. Solvents are pressure fed through the trans & that causes some of the old seals & gaskets to possibly fail. Now, a fluid change, which is different, would be OK. In a fluid change, they drop the trans pan, change the filter, put back the pan & refill the fluid. Just use the recommended fluid, don't put any additives or anything like that in there. If there's no problems, don't ask for any.

Look at the fluid and smell it. It should be red and not smell burned. Honda have tranny drain plugs on the side of the pans. Drain it out, should be 3 quarts. Refill and do it again after a few hundred miles. That should pretty much give you new fluid. Don't get it flushed.

I agree with all the other answers. Do not flush this transmission but definitely change the fluid and filter. In addition use only genuine Honda ATF DW-1 transmission fluid and nothing else.

Honda America recommends that Honda transmissions never be flushed. Drain and fill only.

If the fluid has never been changed it would be a good idea.
If the car is well cared for it's not that old mileage wise.

Your friend is not going to be your friend for long. He didn't take care of the car when he had it and he wants to tell you what you should do? He knows something he is not telling.

Just do a drain and fill, no need to flush it out. Keep doing drain and fill when recommended and I believe it is every 30,000 miles

Nope. Honda's should only get a drain and fill according to their literature. I usually do mine at 30-40,000 mile intervals.