The high prevalence of obesity in the elderly and the increase in life expectancy pushed up the age limit as an indication to bariatric surgery. Nevertheless, results on safety and effectiveness of these procedures in over 60 years old population are still controversial. Objectives of the study were to evaluate the safety and effectiveness of bariatric surgery in the elderly. A prospectively collected database was queried for patients older than 60 years who underwent laparoscopic bariatric procedures between 2010 and 2017 at a single institution. These patients were matched with a group of younger patients who had the same procedure in the same period of time. Basal characteristic, intra- and post-operative data were compared. Patients were followed up at 36 months reporting the percentage of excess weight loss (%EWL) and comorbidities remission rate. A total of 100 patients ≥ 60 years old were included (Group 1) and matched with a control group of 96 patients < 60 years (Group 2). Post-operative complications rate was similar (15.0% versus 10.4% p = 0.395). %EWL at 36 months was significantly higher in Group 2 (44.6% versus 68.2% p < 0.001), while remission of medical morbidities was similar in both groups, with a higher rate for type 2 diabetes (T2D) remission among older people (p = 0.017). Patients older than 60 years have post-operative outcomes comparable to younger population. Long-term results are inferior in terms of %EWL, but similar regarding morbidities remission rates, with particular benefits on T2D.