From April 1, 1990, to March 31, 1992, 8,899 patients who were 65 years of age and older underwent an anesthetic and surgical procedure in a 1,000-bed community hospital in Victoria, British Columbia, Canada. The hospital has been using a proprietary system called MedisGroups for assessing the severity of illness on admission and in-hospital morbidity. All patients were followed up until death or discharge from the hospital. Using the hospital database, we analyzed the patient sample to test the hypothesis that severity of illness was more important than age in predicting postoperative morbidity and mortality rates. Using correlation and multiple regression analysis, we found that the severity of illness was a much better predictor of outcome than age. The results were significant at the level of p < 0.001. Based on the results of this study, we recommend that age not be used in surgical decisions in the elderly.