During two months in the winter and two in the summer information was gleaned about all patients aged 70 and over attending a large accident and emergency department. Comparative figures for the same periods over the previous 20 years showed an increasing number of elderly attendees, the increase being closely related to the increasing proportion of elderly in the population. Using national census data, attendance rates were shown to increase dramatically with age. With increasing age more elderly attended as a result of accidents in the home. The information suggested that social isolation and paucity of support in the community may be responsible for the decision to come to hospital rather than to consult the general practitioner.The elderly attend accident and emergency departments for a wide range of problems but some do so solely for socioeconomic reasons and are particularly difficult to help.