Surgical site infections (SSIs) account for 11% of nosocomial infections among older patients. This report reviews the available data and presents medical and surgical perspectives on the epidemiology, outcomes, and prevention of SSI in the elderly population. The risk for SSI does not seem to increase after the age of 65 years. Several risk factors for SSI are similar among elderly patients and younger patients, but financial factors and factors related to health services may differ between the groups. The clinical presentation of infection and the pathogens that cause infection are similar among elderly patients and younger patients. However, the mortality rate, the duration of hospitalization, and the costs associated with hospital care are greater for elderly patients with SSI than for younger patients with SSI. Several modalities for SSI prevention have been well studied in the general surgical population but have not been specifically evaluated in the elderly surgical population. Insights and opinions pertaining to modalities for SSI prevention in the elderly population and areas of import for future research are discussed.