As the exponential growth in the elderly population occurs, it is essential that we identify age-specific risk factors that impact the outcome of injury in the elderly. In this review article, we describe the different mechanisms of injury that threaten the elderly. There will be a description of ground-level falls-the most common form of trauma-related injury in that group (and how community-based programs can help prevent the complications associated with them). Other injury mechanisms such as motor vehicle collisions and pedestrian-related trauma will be discussed. In addition, abuse of the older patients and the specific screening tools that clinicians can use to recognize victims are described. A review of threats to any population is not complete without examining the impact of firearms. The article concludes with a topic less explored in the medical community-the use of firearms by elderly patients and the impact of dementia on gun ownership. It is essential that the acute care surgeons and other clinicians understand these injury risk factors to better serve their community with injury prevention efforts such as advocacy and education.