Objective To investigate the clinical features of severe trauma in the elderly and analyze the risk factors for death. Methods Clinical data of 130 elderly traumatic patients and 120 young and middle-aged traumatic patients admitted in Intensive Care Unit (ICU) of our hospital from January 2010 to October 2014 were collected and retrospectively analyzed. The cause, traumatic condition, treatment and prognosis were analyzed and compared between the 2 groups. Results In the elderly trauma group, the scores of acute physiology and chronic health evaluation Ⅱ (APACHE Ⅱ) was 19.71±12.48, 39.2% of them had comobidities, their mean length of ICU stay was (6.17±5.97)d, the rate of mechanical ventilation was 56.2%, the incidence of multiple organ dysfunction syndrome (MODS) and pneumonia were 36.9% and 22.3%, respectively, and the mortality was 34.6%. All these values were significantly higher than those in the young and middle-aged group (P＜0.05). Conclusion The mortality is higher in elderly than in young and middle-aged traumatic patients. The APACHE Ⅱ score, more comobidities and occurrence of MODS are the independent risk factors for death.