The authors examine issues related to violent behavior exhibited by elderly patients during episodes of mental illness that are severe enough to warrant psychiatric hospitalization. The medical records of 195 geriatric patients admitted to a psychiatric hospital over a 9-year period were reviewed. During the 2 weeks before admission, 20% of the geriatric patients physically assaulted others, 20% engaged in fear-inducing behavior, and 60% were not violent. Patients with senile organic psychotic conditions were significantly more likely to attack others than were patients with other diagnoses. The most common victims of the patients' violent behavior were family members. The authors discuss the implications of these findings for treatment of geriatric psychiatric patients and their families.