Demand in emergency care has been growing progressively in recent years and this increase is more pronounced in the elderly population. Taking into account that the elderly patient requires more complex evaluations with a greater requirement for complementary tests and consultations with other specialists, longer stays in the emergency ward and a greater percentage of admissions, the progressive ageing of the population might come to have a serious repercussion on hospital emergency departments. It is vital to detect high risk elderly patients before assigning them a definitive placement. For this purpose it is important to install a sieving process amongst elderly patients who attend the emergency department in order to select those that will benefit from a comprehensive geriatric assessment and thus be able to design a specific care plan. Emergency intervention in elderly patients should not be faced exclusively as a medical problem, but functional, mental or social aspects should be taken into account. This represents a challenge for emergency care. This article considers different aspects such as the detection and assessment of the geriatric patient, as well as establishing certain recommendations for emergency setting.