Operative and nonoperative management of colorectal diseases in elderly patients will become increasingly common in our medical practices as the percent of elderly patients increases. A patient's age should no longer be perceived as a "risk factor" in and of itself in deciding management issues. Rather, associated medical conditions need to be optimized and the patients managed more aggressively and not less aggressively on an individual basis to ensure a favorable outcome. Early surgical intervention on an elective basis is preferable to allowing the condition to deteriorate to the point where an urgent or emergency operation is required. The application of new technology such as laparoscopy seems promising but may be limited by side effects and coexisting medical diseases in these elderly patients.