In the last 12 years, 239 patients over 65 years old with gastroduodenal ulcers have been operated on in the Surgical Clinic of the University of Mainz. The main indication was gastric ulcer (n = 161), followed by duodenal ulcer (n = 78), including an emergency operation in the event of bleeding and perforation. Mortality was 6.5% in patients with uncomplicated ulcers, 27.7% in those with complications. Billroth I or II stomach resection was performed most frequently. The perforation was oversewn, the abdomen washed and drained. Selective proximal vagotomy is a first-choice method only in the treatment of the uncomplicated duodenal ulcer. Operative results can be considerably improved by operating early on uncomplicated gastroduodenal ulcers. After the appearance of complications, the principles for surgery on old people should be closely observed, i.e. an operation as minor, short and safe as possible.