Long-term management of more than one language has been suggested to lead to changes in cognition and the brain. This is particularly documented in older age, where bilingualism is associated with protective effects against decline, for example, affording compensation for symptoms of Alzheimer’s disease leading to delayed diagnosis relative to non-bilinguals. Herein, we focus on potential bilingualism effects in the hippocampus, a brain structure related to memory that is particularly vulnerable to cognitive ageing. Hippocampal volume has been shown to increase as a result of second language learning and use in younger adults. However, we do not know if this is maintained over the lifespan, that is, what the long-term effects might be examined in ageing. Herein, we examine hippocampal volume and performance in episodic memory tasks in healthy ageing long-term bilinguals compared to monolinguals. Results show greater hippocampal volume for the bilinguals, which was correlated to individual-level quantified use of the two languages. Thus, our results mirror that of immersive active bilingualism in younger populations. No significant effects of bilingualism were reported on episodic memory task performance. Our findings suggest that long-term active bilingualism leads to neuroprotective effects in the hippocampus, which we discuss in the context of the proposed bilingualism-induced brain reserve in older age literature.