The presence of comorbidities, age-related physiological decline, unrecognized indicators of shock, and under-triage, often combined with a seemingly benign mechanism of injury, poses a unique challenge in the geriatric population. Trauma is the fifth cause of death in the elderly, with falls from standing height the leading cause of high-energy injuries in the geriatric population ((COT) ACoSACoT. National Trauma Data Bank Annual Report 2016. 2016 [cited 2020 August 21]; Available from: https://www.facs.org/quality-programs/trauma/tqp/center-programs/ntdb/docpub). For a similar mechanism of injury, geriatric patients are nearly seven times more likely to present with a higher injury severity score (Henary et al. Traffic Inj Prev. 7(2):182–90, 2006; Lowe et al. J Orthop Trauma. 32(3):129–33, 2018). While traumatic brain injuries are the leading cause of mortality and morbidity in this population (Thompson et al. J Am Geriatr Soc. 54(10):1590–5, 2006), musculoskeletal injuries of the pelvis, hip, and extremities are most commonly seen due to osteoporosis. The cervical spine in older adults is more vulnerable to fractures and spinal cord injuries, with the odontoid and C1–C2 level most commonly affected (Mandavia and Newton, Emerg Med Clin North Am. 16(1):257–74, 1998; Lomoschitz et al. Am J Roentgenol. 178(3):573–7, 2002). The hospital course must follow an interdisciplinary approach to the elderly trauma patients to ensure adequate medical, functional, and psychosocial support. Although there is no evidence supporting the routine use of palliative care in the geriatric population, withdrawal of support remains more common in the very old patient (Aziz et al. J Trauma Acute Care Surg. 86(4):737–43, 2019).