Purpose: To analyze spread of odontogenic infections in the elderly, especially the prevalence and characteristic multidetector computed tomography (MDCT) findings. Materials and methods: Ninety-seven patients with odontogenic infection who underwent 64-row MDCT were evaluated in this study. The study patients comprised 31 elderly patients (≥ 60 years) and 66 adults (< 60 years). Age, gender, location of causal tooth, and spread of odontogenic infections with MDCT were analyzed. Results: The elderly patients (74.2%) had higher ratio with female compared to the adults (57.6%). The buccal space (93.5%) was the most common spread of odontogenic infections for the elderly patients, followed by the masticator space (54.8%) and submandibular space (45.2%), whereas the buccal space (97.0%) was the most common spread of odontogenic infections for the adults, followed by submandibular space (65.2%) and masticator space (51.5%). Logistic multivariate regression analysis for odontogenic infections in the elderly demonstrated that the gender (odds ratio = 3.462, P = .024) and submandibular space (odds ratio = 0.168, P = .013) were significant variable. Conclusions: The study showed the prevalence and characteristic MDCT findings of spread of odontogenic infections in the elderly.