Using hospital admissions data, medical records, and the Consultation-Liaison Outcome Evaluation System, we studied psychiatric consultation to hospitalized medical-surgical patients who were aged 60 years or older. In comparison with younger patients, the geriatric population was less often referred for psychiatric consultation. Those referred had less prior psychiatric history than the group aged less than 60 years. They received a different distribution of psychiatric diagnoses. Consultants recommended psychotroplc medication and diagnostic actions more often for the elderly; the former was related to the presence of organic mental disorder. Concordance with consultants' recommendations and diagnoses did not vary with patients' age. Certain aspects of the consultation process are thus modified when geriatric patients are Involved, and specific features of "geriatric consultation" are unique.