BACKGROUND This study was performed to evaluate the results of massive lower gastrointestinal bleeding in the elderly patients. METHODS The data of patients older than 60 years with massive lower gastrointestinal bleeding were retrospectively analyzed between January 1999 and March 2002. RESULTS There were 14 (52%) males and 13 (48%), females with mean age of 70.2 years (range 60 to 88). Twenty patients were diagnosed with colonoscopy. Angiography was employed in six, scintigraphy in three and r- enteroclysis in two patients. Colonic diverticulosis was the leading etiologic factor (48%). Mean comorbidity and hospital stay were 1.59 and 6.7 days, respectively. Conservative treatment were performed in eighteen, band JCC, ligation in three, surgery in five and embolization in two patients. Mortality rate was 26%. Mortality was high it in patients who had a lower initial diastolic pressure and required more transfusions (p:0.006 and p:0.025, respectively ) CONCLUSIONS Massive lower gastrointestinal system bleeding in the elderly with comorbidities is associated with higher rate of mortality. Surgery in these patients has high mortality rates. Endoscopic and conservative diagnosis and treatment methods should be the first choice in the elderly. Key words: Bleeding, lower gastrointestinal system, elderly.