BACKGROUND The Mini-Mental State Examination (MMSE) or Folstein test is a 30-point questionnaire that is used extensively in clinical and research settings to measure cognitive impairment. It is commonly used in medicine and allied health to screen for dementia. It is also used to estimate the severity and progression of cognitive impairment and to follow the course of cognitive changes in a n individual over time; thus making it an effective way to document an individual's response to treatment. The MMSE's purpose has been not, on its own, to provide a diagnosis for any particular disease.The aim of the study is to observe the cognitive status of elderly patients attending Geriatric Outpatient clinic, Rajiv Gandhi Government General Hospital, Madras Medical College, Chennai using Folstein's Mini-Mental State Examination and study the same with respect to Gender and Education. MATERIALS AND METHODSDesign-A hospital-based, prospective, observational study. 109 elderly patients were selected and Mini-mental State Examination (MMSE) was done. The Sample size was selected for convenience. Co-existing morbid conditions were also recorded. RESULTSIn MMSE performance among elderly-1. Out of 109 participants 68 participants had scored 25 and above, 29 participants had scores between 24 and 19 suggesting mild cognitive impairment and 12 had scores <18 suggesting severe cognitive impairment. 2. There was no statistical difference between the two genders. (p>0.05). 3. Literates fared better than illiterates (p<0.05). CONCLUSIONThe validity of the MMSE should be considered with caution and confirmed with other relevant tests to assess cognitive function in the elderly population.