OBJECTIVE To investigate how elderly people with alcohol-related problems present to medical services and examine their further management in terms of rehabilitation. METHODS Retrospective case-note study. METHODS South Manchester. METHODS 176 patients aged 60 and over admitted between January 1992 and April 1996 with ICD9 diagnoses of alcohol dependence or alcohol abuse. METHODS Medical notes of subjects aged 60 and over with an ICD9 diagnosis of alcohol dependence or abuse were reviewed. Admission episodes by age group and specialty, reason for presentation and follow-up arrangement record were noted. Frequency and specialty of admission were noted for all patients aged 20-95 with the above diagnoses for the above period from PAS (Patient Administration System). RESULTS One hundred and seventy-six elderly patients (representing 244 episodes) were admitted with a diagnosis of alcohol dependence or abuse. Twenty-nine% of the admissions were to psychiatric services and 71% were to medicine or surgery. Of the 125 admissions where medical records were available, 50% were due to falls. Only 15% were referred on for rehabilitation. In contrast, 1441 patients (2524 episodes) aged 20-59 were admitted over the same period. Seventy-eight% were admitted to a psychiatric ward and 22% to non-psychiatric facilities. CONCLUSIONS Alcohol-related problems in the elderly might present as physical problems. Most of these presented as falls and only a small proportion were referred on for rehabilitation.