Diseases of the colon, especially cancer, are age-specific and thus occur more frequently in an aging population. Early diagnosis is prognostically decisive. Indications for coloscopy are often delayed in the elderly. It was the aim of this study to determine advantages and disadvantages of coloscopy in those aged over 80 years.A total of 157 coloscopies in patients aged over 80 years (average 83 years, oldest patient 94 years) were retrospectively analysed (63 males, 94 females) regarding indications, results and complications, with special reference to cancer of the colon. The main indication for coloscopy in this cohort was occult faecal blood or non-acute rectal bleeding (27%), which together were important indicators of endoscopically significant findings (in 76%). Not only blood in the stool but manifold other signs can point to colorectal carcinoma.Even in patients aged over 80 years coloscopy is a safe and well-tolerated investigation. Its results can be improved by thorough pre-investigational intestinal preparation so that repeat examination is unnecessary. The high incidence of significant findings and the easy accessibility to the site of colon cancer should provide an earlier and more common indication of total coloscopy in this age group.