Pediatric patients are not just “little adults” and elderly patients are not just “old adults.” The elderly patient experiences physiologic and anatomic changes that affect all body systems. Providing trauma care for the elderly presents a particular challenge. Muscle atrophy, osteoporosis, and decreased subcutaneous tissue make the elderly patient more prone to a greater severity of injury. Alterations in the cardiovascular and respiratory systems limit the physiologic reserve the elderly need to respond to hypoxia and shock. Preexisting health conditions further complicate the picture. This article highlights some of the important differences in caring for an elderly trauma patient from resuscitation to rehabilitation.