This article examined issues in the care of the injured elderly patient. Past studies have documented variable potential for functional recovery in survivors of serious trauma in the elderly population, and trauma care for this subgroup uses health care resources at an exaggerated rate. Excessive health care costs arise from increased postinjury morbidity and mortality in the elderly population; factors that predict mortality include injury severity, advanced age, and complications. Recent work has focused on the frequency of preventable complications, particularly critical care management errors, in trauma patients of all ages. It appears that the impact of preventable complications on mortality may be greatest in the geriatric trauma victim. Current recommendations for care of these patients include aggressive treatment of all injuries according to standard trauma practice. Routine ICU admission with a low threshold for the institution of invasive monitoring to guide therapy is recommended for all geriatric trauma victims with moderate to more serious injury. The development of specialized management approaches for care of the injured elderly patient will result from ongoing study of this population, as research efforts provide more information about the physiologic and metabolic responses to injury in the elderly population.