Elderly-onset inflammatory bowel disease (IBD) will be seen more frequently with the ageing of the population and the increasing incidence of IBD. However, knowledge regarding the best approach to IBD in this population is scarce. Furthermore, differential diagnosis in elderly patients with diarrhoea, rectal blood loss or a changed defecation pattern is comprehensive and IBD is not always considered. In this case series, we present three elderly patients with late-onset IBD, demonstrating the difficulties in diagnosing and treating IBD in this patient population; in addition an overview of IBD in the elderly is provided.