Cholecystectomy was performed in 93 patients over the age of 70 years with an overall mortality of 7.5 percent. Complications occurred in 28 percent. Patients who underwent elective operations fared far better than those who required emergency surgery. Of the 50 patients who underwent elective cholecystectomy, there was 1 death (2 percent), and 10 patients (20 percent) experienced complications. In contrast, of the 43 patients who required emergency operation, 6 died (14 percent). Complications occurred in 14 (33 percent). Elective cholecystectomy in the elderly patient with symptomatic biliary tract disease is advocated before acute complications that necessitate emergency operation develop.