Summary Health promotion is a mode of practice which is being increasingly examined by policymakers (DHSS, 1987; DoH, 1992). Although practitioners are being required to screen people over 75 years of age and are exhorted to reduce accidents in the elderly by 33% between 1990 and 2005 (DoH, 1992), there is evidence that they do not value this sort of work (Pursey & Luker, 1993). This paper looks at the findings from 178 interviews with people aged over 75 years, examining the importance of health and health promotion to the elderly. Further to the work of Cox et al. (1987), it is clear that people aged over 75 years continue to engage in a wide variety of activities which are designed to keep or improve their health. Elderly people's accounts of their health suggest that the real influence of social circumstances and environment must be assessed and planned for if health promotion activity is to have relevance and meaning to this group of people. Evidence is presented which indicates that the elderly are a group of people who would welcome health‐promotion activity provided it is given in easily accessible forms. The notion of client participation is highlighted as a difficult area, which is likely to require particular skill in working with elderly clients. In the light of these findings, practitioners may need to examine their own attitudes to their work with the elderly.