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Introduction: Tap water scalds among those >or=60 years old are often attributed to physical impairments with aging. This study assesses socio-economics associated with tap water scalds among seniors and the elderly., Methods: Charts of patients admitted to an urban Burn Center between 7/00 and 6/04 for treatment of tap water scalds were reviewed. Demographics, injury details, co-morbidities, surgical interventions/critical care requirements, length of stay (LOS), disposition and related economics were reviewed., Results: During the study period, 68 patients >or=60 years were hospitalized for treatment of these scalds. Mean age and burn size were 78+/-1 years and 7+/-0.9% TBSA. Over 98% of patients were admitted with pre-existing co-morbidities; 60% required ICU care for 40+/-5 days; 22% required mechanical ventilation and 71% required surgery. LOS was 34+/-4 days. Most patients received government assistance income. Pre-injury, 32% resided alone. Post-injury, 10% of patients returned home alone; mortality was 22%. Per patient hospital costs approximated $113,000., Conclusion: These findings report that tap water scalds result in significant morbidity, mortality and health care costs for local seniors and the elderly. Socio-economic factors play a significant role in these injuries and must be assessed when planning prevention efforts.