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Background: Liver resections (LR) for colorectal metastases have been established to prolong survival with acceptable morbidity; however, with limited health resources candidacy of the elderly for such operations has been questioned in terms of safety and efficacy. Aim: To determine 30-day mortality, overall survival (OS), and morbidity after liver resection for colorectal liver metastasis (CRLM) in patients ≥75y old in comparison to patients 60-74y of age. Methods: Patients ≥75y (n=68) (Group 1) were matched on ASA status with patients 60-74y of age (n=67) (Group 2) who underwent LR for CRLM between January 1996 and December 2005. Retrospective review of medical records was performed to compare outcomes between both groups. Results: Females constituted 49% and 28% of Group 1 and Group 2, respectively (p =0.02). Eighty-one percent and 19% of the Group 1 and 67% and 33% of Group 2 had colon cancer and rectal cancer, respectively. Sixty-four percent of Group 1 and 71% of Group 2 had node positive disease of the primary tumor. A major LR (lobectomy or extended lobectomy) was performed in 30.9% of Group 1 and 41.8% of Group 2 patients, p=0.21. One patient in the older group underwent a portal vein embolization vs. two patients in the younger cohort. There was no difference in the overall morbidity rate between Group 1 (14.5%) and Group 2 (19.7%), p=0.50). There were no significant differences in age groups and Clavien Grade 1-V postoperative complications (p=0.08). There was only one death at 30-days and it occurred in Group 1. Median hospital stay for both groups was 7 days (p=0.35). Fifteen percent of patients in Group 1 required ICU stay compared to 10% in the younger cohort (p=0.46). Adjuvant chemotherapy was administered more frequently in Group 2 (51%) compared to Group 1 (25%; p=0.002). There was no significant association between the age groups for disease recurrence (p=0.44) with a 5-year recurrence-free survival of 53.9% in Group 1 and 50.2% in Group 2. There was no difference in 1-, 3-, 5-year, OS between the two groups (p=0.21) with a 5- year survival of 22.3% and 37.2% respectively. On multivariable analysis, evaluating age 60-74 vs ≥75, sex and postoperative complications (minor and major vs no complication) there was no significant difference in survival between both groups (HR 0.64 (0.37-1.08), p=0.09). Conclusion: Liver resection in elderly patients is safe with acceptable morbidity rates comparable to those of younger patients. Therefore chronologic age alone should not be a contraindication for aggressive treatment, and should be considered in carefully selected patients.