In this study, we attempted to compare facial trauma of late-middle-age patients (55-64 years, LM group) and old-age patients (>65 years old, OL group). The goal of this study was to evaluate the natural history of facial trauma in geriatric patients.The medical record of patients older than 55 years seeking treatment for facial trauma between March 2006 and February 2009 were reviewed, and parameters were collected. Seven hundred seventy-two patients (553 male, 219 female) were analyzed. There were 438 patients of the LM group (55-64 years old) and 334 patients of the OL group (>65 years old).In men (n = 553), the number of patients within the LM group (n = 336, 60.8%) was greater than the number in the OL group (n = 217, 39.2%). Of the 219 women, the number within the OL group (n = 117, 53.4%) was greater than that within the LM group (n = 102, 46.6%) (P = 0.000, χ). Facial lacerations comprised a significantly higher proportion in the OL group (79.3%) than that in the ML group (70.1%), whereas facial bone fractures were more frequent in the ML group (29.9%) than in the OL group (20.7%), which was significant (P = 0.004, χ). Assault and automobile accidents were significantly more frequent in the ML group (n = 65 [15.1%] and n = 31 [7.2%], respectively) than the OL group (n = 20 [6.0%] and n = 11 [3.3%]), whereas falls and pedestrian accidents were more significantly frequent in the OL group (n = 30 [9.0%] and n = 23 [6.9%], respectively) than in the LM group (n = 30 [7.0%] and n = 19 [4.4%]) (P = 0.000, χ). During the hours of the day, between 4 to 6 PM and 6 to 8 PM, injuries occurred more frequently in the OL group (14.5% and 12.4%, respectively) than in the LM group (10.5% and 11.0%, respectively). At the times of 8 to 10 PM and 10 PM to midnight, however, injuries occurred more frequently in the LM group (17.1%, 12.1%, respectively) than in the OL group (12.1% and 8.2%, respectively) (P = 0.03, χ). Frequency of injuries at home within the OL group (n = 68, 22.2%) was significantly higher than within the LM group (n = 55, 14.4%) (P = 0.001, χ), whereas frequency of injuries at the workplace of the LM group (n = 47, 12.3%) was significantly higher than that of the OL group (n = 16, 5.2%) (P = 0.001, χ). Alcohol ingestion at the time of injury was significantly more frequent in the LM group (n = 146, 34.1%) than in the OL group (n = 57, 17.3%) (P = 0.000, χ). In regard to diabetes, the OL group (35.6%) showed a higher prevalence than that of the LM group (25.4%; odds ratio, 2.65).Prevention of injury is important for elderly patients. It is worthy of notice that more than one fourth (26.8%) were in a drunken state at the time of injury. There were no significant differences in the days of hospitalization or in the interval from injury to operation. However, there were significant differences in the place of the injuries, causes of injuries, and time of injuries, which is important in the prevention of injuries. Attention should be paid to assault and automobile accidents in the LM group and to falls and pedestrian injuries in the OL group. Thus, injury prevention should be prepared for differently for both LM and OL groups.