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Proctocolectomy and ileal pouch anal anastomosis (IPAA) has become the standard surgery for patients with mucosal ulcerative colitis (MUC). Although there is no absolute age limitation, there are concerns as to its use in elderly patients due to the risks of potential complications and poor function. The aim of this study was to assess the complications and outcome of patients over the age of 70 years with MUC who underwent IPAA. Results in these patients were compared to the results in a group of patients aged less than 70 years who had IPAA.After Institutional Review Board approval, a retrospective review of the medical records of patients with MUC who underwent IPAA was undertaken. These patients were divided into four age groups: < 30 years of age, 30–49 years, 50–69 years, ≥ 70 years.From 1989 to 2001, 330 patients underwent IPAA for preoperative clinical and histopathological and postoperative histopathologically confirmed MUC; 17 were aged ≥ 70 years. The mean hospital stay was 5.8 (SEM 0.7) days in the patients aged < 70 years and 6.0 (SEM 0.4) days in the patients aged ≥ 70 years (P = 0.911). Postoperative complications occurred in 39% of patients ≥ 70 years and in 40% in the < 70 years group (P = 0.08). Pouch failure occurred in two (11.8%) patients ≥ 70 years and in 6 (1.9%) < 70 (P = 0.2).IPAA is a safe and feasible option in MUC patients over the age of 70 with functional results similar to results seen in younger patients.