Numbers of aged surgical patients appearing on the operating lists, have sharply increased, also in Japan, during the past twenty years. One of the reasons for this increase in geriatric abdominal surgery is a remarkable increase of the population of aged people or the improved therapeutic results attainable with modern surgical and anesthetic techniques. Obviously, the advancing age is not considered as a factor for indicating an absolute contraindication to abdominal surgery. In Japan, surgical procedures for cancer of the G-I tract, chronic peptic ulcer and gall stone disease are the most common major operations in this patient population. Provided with meticulous pre- and postoperative management and careful and skillful surgical technique, even the patients over 80 years of age are usually capable to tolerate major surgery. Although higher incidence of postoperative complications in this age group account for the postoperative death, the mortality rate after elective major surgery in the aged group has been approaching to the level in the younger age group. Surgeons have to assess the cardiovascular, pulmonary or renal function to estimate the surgical risk in each aged individual prior to surgery. Although the majority of aged patients who are not suffered from the decompensated function of the vital organs or whoo are capable to take care of themselves at home prior to the onset of the present illness, might be able to tolerate major abdominal surgery well, it has to be considered that the adaptability to stress become lesser with aging, and therefore, both surgeons and anesthesiologist must strive to avoid any wide derangement of vital function. On the contrary, the postoperative mortality rate in emergency surgery is fairly higher than that of elective procedures. It might be concluded that, although the majority of geriatric patients should be estimated as poor-risk patients for abdominal surgery, meticulous observation, careful judgement, skillful technique and dedicated pre- and postoperative care will give many aged surgical patients happy life thereafter.