To evaluate the effects of age and physical status on postoperative complications, American Society of Anesthesiologists-Physical Status score (ASA score) and age were analyzed in patients undergoing pancreatoduodenectomy (PD). Medical records and follow-up results of 69 patients who had undergone PD from 1980 to 1993 at one institution were examined. Clinical variables affecting morbidity and mortality rates were analyzed, and compared between two-aged groups (> or = 70 years (n = 18) and < 70 (n = 51)). Univariate Cox regression analysis of 69 patients showed that ASA score and age were not significant factors affecting postoperative morbidity, mortality, and survival. The clinical variables including ASA score, gender, operative time, blood loss, stage, and location of carcinoma were similarly distributed between the two-aged groups. The mortality rate in patients less than 70 years of age was 5.9 per cent (3/51), whereas there was no mortality in patients more than 70 years of age. The morbidity, mortality, and cumulative survival rates were statistically similar in the two age groups. The results suggest that ASA-physical status and age are not limiting factors for PD and do not predict survival. The procedure is safe and worthwhile even in patients more than 70 years of age with the ASA score up to III.