Hospital utilization by persons aged 85 or older before the development of a specialized geriatric service in a Canadian city is described. Admissions to surgical units slightly outnumbered those to medical units and were more likely to be elective admissions or interhospital transfers. Three fourths of the medical admissions were classified as "emergent," and half of the admissions came through the emergency department. Although a number of patients, particularly older women, came from extended care facilities, most patients had been living in the community before admission. The mean length of stay was 18.8 days and the in-hospital mortality rate was 13 per cent. The majority of patients were discharged to the community, and this placement appeared stable, in that less than 10 per cent of those discharged to the community entered an extended care facility within the one-year follow-up period.