Accidental hypothermia is unintended body core temperature of 35 degrees C or below, a known hazard to elderly people in temperate and cold climates.We present two old patients with severe hypothermia and a review of the literature focusing on risk factors, clinical presentation, and the treatment of hypothermia in the elderly.Two patients, aged 90 and 102 years, with body core temperature < 28 degrees C were successfully treated at Ullevål University Hospital, Oslo, Norway with slow active external rewarming and a low stress strategy as recommended in the geriatric literature. Successful treatment with more rapid rewarming and use of internal rewarming like peritoneal lavage has also been published. The prognosis of elderly victims of hypothermia is known to be worse than for younger individuals. Epidemiological data are scanty. The most important risk factors are connected to ageing itself and to the morbidity often found in elderly hypothermia victims. Treatment is based on experience from few cases, minor prospective studies mainly on rewarming of younger patients and clinical experience from younger patients.There is a need for more knowledge and experience of treating elderly hypothermia victims.