OBJECTIVES: To assess the patient-, hospital-, and discharge-level characteristics, and hospitalization rates among elderly patients with cancer in the United States (US). Hospitalization outcomes (length of stay [LOS], total charges, and mortality) among elderly patients with cancer were also studied. METHODS: A cross-sectional descriptive analysis of the 2009 Healthcare Cost and Utilization Project (HCUP) database was conducted. Patients were identified based on diagnosis (any-listed) of cancer using Clinical Classification Software (CCS). A control group of patients without cancer were identified by matching on age and gender (1:2 case-control). Analyses were conducted using PROC SURVEY procedures in SAS v9.2. RESULTS: In 2009, a total of 3,325,174 (weighted) hospitalizations occurred among elderly patients with cancer in the US. Elderly cancer patients had higher total hospital charges ($39,406 vs. $37,756), longer LOS (5.7 days vs. 5.4 days), and higher mortality (4.8% vs. 3.6%) as compared to those without cancer. A greater proportion of hospitalizations among cancer patients occurred in teaching hospitals (44.1% vs. 38.9%; p<0.001).  In terms of location, a greater proportion of hospitalizations for cancer patients occurred in hospitals located in urban areas in comparison to those without cancer (88.1% vs. 84.7%; p<0.001). Total charges for hospitalizations among elderly patients with prostate (average LOS=4.9 days), lung (average LOS=6.1 days), and breast cancer (average LOS=4.9 days) were roughly $19.2, $16.1, and $16.0 billion, respectively.  Mortality rates during hospitalization were the highest for those with pancreatic (10%), liver (9.7%), and lung cancer (8.7%). CONCLUSIONS: Elderly patients with cancer had significantly greater hospitalization burden as compared to those without cancer.  Hospital mortality rates were the highest for elderly patients with pancreatic, liver, and lung cancer, respectively.