The results of 93 elderly patients, subdivided in two age groups (> 65 < 80 years; > 80 years), undergoing abdominal surgery in immediate or delayed emergency over the past five years are reported. The overall morbility was 47.3% (48 complications in 44 patients); among the complications, sepsis was the first factor in frequency in either group (group I: 28.1%, group II: 17.2%), and was reported mostly in patients with associated diseases (group I: 61.1%, group II: 60%). Overall mortality was 16.2% (group I: 15.6%, group II: 17.2) related to 15 patients; among them, 10 had associated diseases (66.6%). The authors try to identify risk factors and their influence in prognosis and propose a multidisciplinary approach in the pre and postoperative period.