OBJECTIVE The purpose of this study was to report perioperative morbidity and mortality rates in elderly women who undergo gynecologic surgery. METHODS The charts of 54 consecutive women ages 70 to 85 years who underwent major gynecologic surgery between June 1998 and November 2002 were reviewed retrospectively. RESULTS The mean age was 76.7 years. Fifty procedures (92.6%) were performed for pelvic organ prolapse and/or urinary incontinence. Forty-nine of the procedures were performed vaginally, and 27 of the procedures (50%) were performed with the use of general anesthesia. Postoperative cardiac complications occurred in five patients (10%), including three myocardial infarctions, two of which were fatal. Other complications included benign cardiac arrhythmias in two patients, slow return of gastrointestinal function in five patients (9.3%), and transient mental status changes in four patients (7.4%). The mean length of stay was 4 days. CONCLUSIONS Postoperative complications occurred infrequently among elderly women who underwent gynecologic surgery. Although age alone is not a contraindication to elective surgery, there may be increased risks for geriatric women.