Background <p>The world is experiencing a demographic shift towards a larger proportion of older people. This has important consequences for the healthcare system, including neurosurgical departments. Geriatric patients represent a range of unique challenges related to treatment, resource allocation, prioritization and ethical concerns. In order to meet the challenge of increasing demand of geriatric neurosurgical care, and prepare for planning and establishment of health service requirements, we must first understand the demographic trends, common diagnoses, and types of procedures geriatric patients undergo. The objective of this study is to investigate and report these parameters.</p> Methods <p>Data was retrieved from the Lifecare Orbit Surgical Management system on all geriatric patients (≥ 65) treated at Haukeland University Hospital from January 1, 2018, to December 31, 2023. The dataset included date of birth, date of surgery, duration of surgery, procedure codes, diagnosis codes, and type of admission. Descriptive statistics and linear regression were performed using the R programming language.</p> Results <p>We identified 2,512 patients eligible for inclusion. The most common procedures in our geriatric population were decompression of lumbar spinal canal and nerve roots (8.54%), decompression of lumbar nerve roots (7.38%), and evacuation of subdural hematoma (7.16%). The prevalence of emergency procedures increased with advancing age, and conversely, more complex elective procedures decreased with advancing age.</p> Conclusions <p>We identified a shift towards emergency-driven care and a reduction in complex procedures as patients age. Further analysis of resource utilization and clinical outcomes, such as length of stay, will be essential in guiding future strategies for geriatric neurosurgical care.</p>