Although the elderly make up about 12% of the US population, they account for nearly 33% of health care resources expended on trauma. A review of the literature in the area of geriatric trauma revealed a number of factors that influence the likelihood of injury in the elderly population. These include age-related changes in postural stability, balance, motor strength, and coordination that may predispose individuals to falls and other accidents. It is important to have a high index of suspicion for injury and a low threshold for invasive monitoring and transfer to an intensive care setting. Considerations in the care of elderly trauma patients include comorbid conditions, pre-injury medications, reduced physiologic reserve, and the physical changes of aging.