Purpose: To evaluate our 2-year experience in the emergency surgical treatment of elderly people (aged > or = 80). Method: A retrospective review was conducted of 198 elderly patients admitted to Emergency Surgery Unit of the Ospedale Maggiore in Bologna from 01.07.2001 to 30.06.2003. Results: All the Patients were submitted to emergency operations. Mean age was 84,8 (range 80-96); Female were 152, male 73. Preexisting condition, ASA scores and surgical procedures were recorded. The postoperative mortality was 17,1%. The mean length of stay in our Unit was 9,7 days; 93 patients needed rehabilitation facility at discharge. Conclusion: The Authors concluded that emergency surgery entails a high risk to the patients, high cost in hospital resources and rehabilitation facility.