BACKGOUND: More people are now living to older ages and higher proportions of most countries' populations have lived for at least sixty years than at any time in the past. Today, there are more than 578 million people over 60years in the world, and this generation is growing at an unprecedented rate. Currently, about 77 percent of this increase in the older population is taking place in developing countries. Elderly people tend to have certain progressive diseases and show increased incidence of other diseases, an increased mortality from injuries and insults of all types and they have a diminished reaction to stress, including surgery. AIMS: These were to determine the pattern and outcome of abdominal surgeries in patients 60years and above who were operated at the surgical unit of Obafemi Awolowo University Teaching Hospitals Complex, Ile-Ife, Osun State, Nigeria. METHODOLOGY: This was a 12 month prospective study that included all patients aged 60years and above who had abdominal operation at the surgical unit of Obafemi Awolowo University Teaching Hospitals Complex, Ile-Ife within the study period. Data was collected using a proforma and patients were followed up for a period of 4 to 6 weeks post operatively. RESULTS: Eighty-six patients were studied. The age ranged from 60years to 85 years with mean age of 68.7 (SD± 6.9) years and a male/female ratio of 2.44:1. More than half of the patients in this study presented after 3months of onset of symptoms. Abdominal wall hernias were the commonest indication for surgery in this study followed by Benign Prostatic hypertrophy. Nineteen (22.1%) patients had malignancies. Colonic tumours were the commonest malignancies in this study. The Colonic tumours were all on the left side. Eighteen (20.9%) patients presented with benign intra-abdominal conditions mainly Gastroduodenal pathologies following Peptic Ulcer diseases. Peptic perforation was more common than Gastric Outlet Obstruction in this series. Forty-eight patients (55.8%) in this study had no co-morbid condition. Hypertension was the commonest co-morbid condition in this study. Overall mortality rate in this study was 11.6%. Emergency surgery was a risk factor for high mortality in this study, 29.4% compared to 7.2% for elective surgeries. CONCLUSION: Elderly patients are a heterogeneous group of people. Each patient should be evaluated and treated as an individual not as a group of high surgical risk people. Old age is not a contra-indication to abdominal surgery. Necessary surgery should not be delayed or denied because of advanced age. Elderly patients undergoing general anaesthesia should be optimized and co-morbid diseases treated to make anaesthesia safe to reduce morbidity and mortality, and improve outcome.