Accounts of head injury tend to be dominated by the findings in young males who constitute the majority of victims. We compare 1571 patients aged under 65 years admitted to the Head and Spinal Injury Unit, Edinburgh in one calendar year with 449 patients aged 65 years or over admitted during two one-year periods. In the elderly group: the sex ratio was equal; falls accounted for the great majority of cases, with pedestrian accidents responsible for serious injuries; alcohol was commonly involved in males; injuries were most frequent on Thursdays; intracranial haematomas and mortality rates were higher; and the length of hospital stay more prolonged. The provisions necessary to meet the needs of the elderly within a head injury service are discussed.