Introduction: Age is linked to an increase in the incidence of a variety of diseases and disabilities, as well as a loss in the functional reserve of numerous organ systems and a gradual reduction in personal and social resources. A serious shortage of intensivists and ICU beds is expected as a result of existing unitization practices. In 2006, approximately 50% of all admissions to intensive care units were elderly patients, and those patients consumed 60% of all ICU days. Further, during the last 6 months of life, ICU days account for 25% of all Medicare dollars spent. Aims: This study aimed to predict the risk factors of intensive care unit mortality in critically ill elderly patients __ampersandsignge;65 years old with special emphasis on age as a predictor of poor outcome. Methodology: This is a retrospective cohort historical study carried out for one year from January 2015 to January 2016 at the intensive care unit of Teaching Hospital, Menoufia Governate. A total of 800 consecutive patients were included over 12 months, 402 (50.2%) were male and 398(49.8%) were female aiming at assessment of risk factors of their in-hospital mortality with special emphasis on age as a predictor of poor outcome. Results: There were statistically significant differences between survival and mortality among patients regarding cardiac, renal and electrolyte disorders, neurological and gastrointestinal disorders, MPM II predicted death rate, hematological and oncologic disorders except Hematological malignancy and pulmonary disorders except Airway diseases. Conclusion: Anemia, thrombocytopenia, non-hematological malignancy, systolic blood pressure__ampersandsignle;90 at admission, C-reactive protein (CPR) prior to admission, vasopressor infusion, and mechanical ventilation were the independent risk factors associated with raised mortality in elderly patients. We should adopt measures to decrease the incidence of these complications to try to reduce mortality. A better comprehension of factors associated with death in the elderly can improve medical care to these patients.