A retrospective review of 131 psychiatric referrals of hospital in-patients aged 65 years and older was made to examine the referral rate, the characteristics of referred patients, and the pattern of diagnoses and recommendations made by the psychiatrist. The referral rate was much less than the estimated prevalence of psychiatric morbidity in similar populations. The majority of referrals received a psychiatric diagnosis, most commonly an organic psychiatric syndrome (37%) or depression (23%). Comparison of various aspects of referral for the periods before and after the introduction of a specific psychiatric liaison service for the elderly showed little change apart from a small increase in referral rate.