Age associated decrease in physiological reserve may lead to varied responses to trauma in the elderly population. In this article, we have reviewed the salient features of geriatric trauma including anatomic, physiologic, and pharmacologic changes with aging, as well as associated co morbidities affecting the outcome of the elderly trauma patients. Moreover, the patterns of common injuries, pre-hospital and emergency department evaluation, initial resuscitation, and anesthetic managements of these patients have been discussed. Recent advances having an impact in the care of the elderly injured patients are discussed with the hope that this will assist the trauma clinicians to become more caring towards the senior citizens.