I have had an interest in surgery in the elderly ever since I cared for patients at a large geriatric center in Baltimore, Md. With the significant increase in our older patients, elderly surgery is now a popular topic for grand rounds and symposia. The message I always try to stress is that 2 issues affect outcome in these patients: the presence of an active comorbid illness (mainly cardiac disease) and emergency surgery. If we get control of these illnesses perioperatively, our elderly patients can do very well. Last month I updated data for my talks and I will show herein that things are looking pretty good for our older patients.