We have studied the hospital mortality and long-term survival in two groups of patients: those between 50 and 69 years of age (group 1, n = 136) and those older than 70 years of age (group 2, n = 43). The two groups were similar in terms of the distribution of histological type and postsurgical staging. The patients were treated by either lobectomy or pneumonectomy; the lobectomy rate was similar in both groups: 61% and 51% (not significant). Hospital mortality for group 1 was 4.4% and for group 2, 6.9%. Mortality was higher in both groups after pneumonectomy compared with lobectomy, but this was not significant (group 1, 6.2% versus 1.9%; group 2, 9.1% versus 4.7%). Hospital mortality after pulmonary resection was greater in the elderly, but this was not significant (lobectomy: 1.9% [group 1] versus 4.7% [group 2]; pneumonectomy: 6.2% [group 1] versus 9.1% [group 2]. The overall long-term survival at 2 and 4 years was 62.3% and 50.0% for group 1 and 72.5% and 66.6% for group 2. We suggest that the operative risk in the elderly is not prohibitive and the long-term results are acceptable. Patients should not be denied operation on the basis of age alone.