A study was made of the pattern of spinal cord injury in the elderly who are forming an ever-increasing proportion of our population. It was noted that the elderly patients had a higher incidence of cervical injuries than other age-groups with a much lower incidence of dorsal and lumbar injuries. The mortality rate in complete cervical injuries was very high but in incomplete cervical injuries and those at a lower level the majority survived the acute phase. The cause of death in the acute phase was similar to that of other age-groups. The majority of survivors were able to be discharged to their own homes to the care of relatives and they fared better than those who had to be transferred to long term geriatric hospitals. Most of the late deaths occurred within five years of discharge from hospital but a few survived over ten years. The causes of the accidents were mostly falls at home and less frequently road traffic accidents.