Early aggressive trauma care has been shown to improve outcome for geriatric patients with survivable injuries, yet elderly patients are more likely to remain in their community and receive care at a non-designated trauma service. Recognition of the increased risk of poor outcome in this population should prompt consideration of early transfer to a higher level of trauma care unless the family or patient has decided not to pursue aggressive resuscitation efforts. Advanced age alone should not be used as the sole criterion for denying or limiting care in this patient population. With the exception of patients who are moribund on arrival, an initial aggressive approach should be pursued as the majority will return home and up to 85 percent will return to independent function.