The results of major surgery have improved enormously in the past 20 years. Not only is surgery now safe for the patient but we are learning something of how to make the patient safe for surgery. As a result, major operations can be carried out at ages, both young and old, which were previously thought to be an absolute barrier. At the same time, with the increased expectation of life common to all civilized countries, the surgery of the elderly patient is becoming increasingly important. In Great Britain, life expectancy at birth for men has increased from 48.5 years in 1900 to 66.3 years in 1950. At the age of 60, life expectancy is 74.8; at 70, it is 79. Moreover, between 1931 and 1951, while the total population of the country increased by 8%, the number of persons more than 70 years of age increased by 72%. Trends in