Little is known about trauma in the elderly in the developing world. This study compared injuries in older patients with those in younger adults in a Third World setting. This was a prospective observational study of trauma admissions to a tertiary hospital in Trinidad, comparing injury characteristics and patient outcomes in older versus younger adults. Falls were the most common mechanism of injury in the elderly, accounting for 71% of injuries. Older patients who fell sustained fractures more often and were most likely to injure the limbs and head. Elderly patients were more likely to be admitted to hospital. Trauma in the elderly in Trinidad is similar to that in the developed world. Public health measures in developing countries should be aimed at preventing falls in older persons. The burden of trauma in the elderly is likely to increase in developing countries as the population ages.