In this first large-scale random sample survey of elder abuse and neglect, interviews were conducted with 2020 community-dwelling elderly persons in the Boston metropolitan area regarding their experience of physical violence, verbal aggression, and neglect. The prevalence rate of overall maltreatment was 32 elderly persons per 1000. Spouses were found to be the most likely abusers and roughly equal numbers of men and women were victims, although women suffered more serious abuse. Implications for public policy are discussed.