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Introduction: The proportion of elderly is increasing steadily in the world's population. Concurrently, the number of elderly patients undergoing surgery for acute appendicitis has also increased. Despite the improvements in medical care, the morbidity and mortality rates remain high. We analyzed the records from the past 40 years to determine if there has been any change in the proportion and/or complications of acute appendicitis in geriatric patients. Materials and Method: We reviewed the operating room and histopathologic records of patients who were operated on for acute appendicitis during the last 40 years (1973-2012). Patients, aged 65 and older were classified as geriatric. Results: In total, records for 3229 patients were analyzed. The mean age was 30.06±13.42, 63.5% of whom were male. A total of 120 (3.71%) patients were 65 years of age or older, with an average of 67.88±3.76 years, and 63.3% of these patients were male. The complicated appendicitis ratio was 55/120 (45.83%) in the elderly. The proportion of the elderly patients has increased gradually from 0.74% to 8.08% by decades. Conclusion: The ratio of complicated appendicitis among aged patients still remains high and nothing has changed in last 40 years in our country as in whole world. [ABSTRACT FROM AUTHOR]