OBJECTIVE: Elderly people who have chronic diseases frequently requires Emergency Department attendances and hospital admissions. Patients staying in Observation room are more prone at risk. We believe many of the geriatric medical and psychosocial problems could be settled in the Observation Room obviating the need of hospitalization. Extended community supportive services, such as community nursing, community geriatric out-reach assessment team; geriatric day hospital can be organized to provide close monitoring of the medical and social problems of AED attendees. METHODS: Geriatric screening program is provided to all elders aged 65 and above who are admitted to Observation Room. Geriatric input includes making diagnosis and management, assessment of common geriatric syndromes, detection of social problems and evaluation of the home care support. In cases of necessity, direct transferal to convalescence hospital, referral to appropriate social services and medical follow up for continuity of care are made. RESULTS: A total of 615 elderly patients were admitted to Observation room during June to August 2004. The Geriatric screening program was evaluated with 234 cases received. One hundred and thirty-five (57.7 %) cases were female. The mean age was 78.2 (SD 7.49).The average length of stay was 1.68 days. Most common complaints were dizziness and vertigo (21.1%), chest pain (14.6%), gastroenteritis (5.7%) and hypoglycemia (4.8%). The program was welcomed by AED colleagues and was helpful in making the diagnosis in 31.3% of patients. Medication was adjusted in 58.1%, and underlying social problems were identified in 13.7%. Majority of patients (81.2%) were discharged back to their original accommodations. CONCLUSIONS: A geriatric screening program in the Observation Room is effective in resolving common geriatric problems and may possibly reduce unnecessary hospital admissions.