The outcomes of tympanoplasty in the elderly are generally no different from those in the young. Although some reports suggest that hearing results were not as good in patients older than 60, the instance of graft failure in these patients did not differ greatly by age. Patients older than 65 do have the highest incidence of perioperative death or complications, with elderly men being at a greater risk than elderly women. The risk is also higher in patients who have concomitant diseases, such as coronary artery disease, congestive heart failure, myocardial infarction, diabetes mellitus, hypertension, renal disease, chronic obstructive pulmonary disease, cerebral vascular disease, dementia, and peripheral vascular disease. The presence of coexisting disease is more important than age itself, although physiologic age is more important than chronological age.