Older adults are living longer due to gains in social condition and medical care with the greatest increases in numbers being the oldest old. The frail elderly face and present to practitioners complex medical, physical, and social issues. The "oldest of the old" adults are more acutely ill and require more complicated care. Topics in this issue discuss the most frequently presented problems of the elderly in emergency care: Abdominal pain, Chest pain, Syncope, Falls, Infections, Hypertension, and Polypharmaceutical issues.