The care of older persons accounts for an increasing proportion of the unscheduled care workload for acute hospitals. The recent development of acute medical assessment units (AMAU) has provided an alternative model for acute unscheduled care for all medical patients. Screening instruments have been developed to capture the higher levels of clinical complexity and medical comorbidities that older patients present with. The aim of this study was to report on the characteristics and outcomes for older patients reviewed in the AMAU of a tertiary referral university teaching hospital. Data on 3071 patients attending the unit over one year was prospectively collected and information on characteristics and outcomes for older patients retrieved. Older patients represented over one third (1066/3071, 35%) of those attending AMAU, and had an admission rate of nearly twice that of younger patients (60.5% vs 32%), highlighting the increased complexity of this group. Gerontologically attuned AMAUs have great potential to enhance care for frail older patients from the time of their acute presentation to hospital.