Falls are the most common cause of trauma in the elderly. Data regarding patterns of injury following geriatric falls are scant. We conducted a retrospective review of falls in patients aged 65 years and older seen at a trauma center over a nine year period. Two thousand eighty three patients met the inclusion criteria. Hip fracture proved to be the dominant injury (55%), 98% of which were isolated. Five hundred seven (21%) were non-hip fractures. Two hundred thirty eight patients (10%) sustained traumatic intracranial hemorrhage. Chest injury was the next most common injury type (6.7%) with rib fractures comprising 86% of this subgroup. A pattern of association between intracranial hemorrhage and cervical spine fractures was identified. Intra-abdominal injuries are rare.