Since the percentage of elderly patients in the United States is increasing, the knowledge of whether radical surgery can be performed on these patients with acceptable morbidity and mortality is important. Therefore, a retrospective study of elderly patients having radical hysterectomy was performed. A retrospective case study of all patients over 65 years of age having undergone a radical hysterectomy in one private community practice of gynecologic oncology was performed. No patients between July 1, 1965, and December 31, 1992, were knowingly excluded. All patients were analyzed for preexisting medical conditions, length of postoperative stay, morbidity, and mortality. Sixty-nine patients who fit the above criteria were found. Preexisting medical problems were found in 72.5% of the study population. Minor morbidity occurred in 14.5% of the group, while major morbidity occurred in 10%. There was no mortality. Lengths of hospital stay were significantly different between patients 65 to 74 (8.7 days) and over age 75 (10.4 days). In conclusion, radical hysterectomy is a safe surgical procedure in patients 65 and over. This is true even in patients 75 and over. Careful preoperative assessment, perioperative monitoring, and meticulous postoperative care is vital to the success of any major surgery, especially in the older patient. (C) 1994 Academic Press, Inc.