PURPOSE: Laparoscopic surgery is used in elderly patients to maximize the benefits of improved postoperative recovery but this supposition lacks proper evidence. The aims of this study were to assess the safety and feasibility of laparoscopic colorectal surgery in elderly patients (group A, age > or =70 years, n=77) by a comparison with those in younger patients (group B, age < or =65 years, n=142), and to define the factors contributing to postoperative complications. METHODS: A retrospective analysis of 219 patients, who underwent elective laparoscopic colorectal cancer surgery between June 2006 and November 2010 at Kyung Hee University Hospital at Gangdong, was performed. The data included the patient's demographics, surgical and postoperative outcomes, including complications and recovery parameters. RESULTS: The mean ages of group A and B were 76 years and 56 years, respectively. Group A had more comorbid conditions than group B, as assessed by the Charlson comorbidity index score (group A 4.09 vs. group B 3.06, p<0.001). The postoperative recovery times were similar in the two groups. Intensive care unit (ICU) stays were more frequent in group A than group B (group A 44.2% vs. group B 6.3%, p<0.001). Postoperative complications were independently related to the long operation time (>200 minutes), ICU stay and rectal surgery. CONCLUSION: Laparoscopic colorectal surgery in elderly patients is safe and does not compromise the postoperative outcomes despite the comorbid conditions of the elderly patients.