The influence of age on the presenting manifestation of acute biliary tract disease was evaluated by retrospective review of all cases in which this diagnosis was confirmed at operation over a 30-month period. Results indicated that acute biliary tract diseases in elderly patients presents in a manner not statistically significantly different from younger patients (p >0.05 for all parameters studied). Although such disorders in the elderly occasionally present in an unusual fashion, the majority of older patients present with abnormalities such as pain, jaundice, fever, and leukocytosis as commonly or even more frequently than younger patients.