The mental health emergency service is a critical triage point for making decisions about the delivery of a variety of services needed by an increasingly large elderly population. This study explores the roles of two mental health emergency services in providing services and linking elderly clients with elements of the health, mental health, and long-term care systems. A data base was established by a retrospective review of 350 records of elderly clients treated at two urban mental health emergency facilities over a one-year period. Key findings are presented about the demographic characteristics of users age 60 and over, diagnoses, referral and disposition patterns, repeater usage, and emergency versus nonemergency usage. Recommendations are made on the future role of mental health emergency services in meeting the complex health and mental health needs of the elderly in the community.