Introduction: Pelvic fractures in the elderly represent a difficult prob-lem for pelvic surgeons, in connection with which the bulk of patients are treated conservatively. Purpose of the study: evaluate the effectiveness of surgical and conservative treatment methods in elderly patients. Mate-rials and methods. A retrospective analysis of the treatment of 32 patients with pelvic ring injuries older than 65 years was performed. There were 24 patients in the conservative treatment group, and 8 patients in the surgi-cal treatment group. Long-term results were evaluated after 12 months, according to the SF-12v2 questionnaire and the “Timed up & go” test.Results. Long-term results after a year in the conservative treatment group were evaluated in 19 patients (76.2 ± 6.7 years). In the conserva-tive treatment group in 7 patients (73.5 ± 5.8 years). Annual mortality was 20.8% and 12.5%, respectively. In the conservative treatment group, 14 patients restored their previous level of activity (73.7%) and in the surgical Etreatment group 6 patients (85.7%). Conclusion. In elderly patients with injuries of the pelvic ring, a high mortality rate remains. In our study, no reliable data were obtained on the advantage of surgical treatment meth-ods compared to conservative treatment tactics. When opting for surgical treatment of pelvic ring injuries, it is necessary to consider the type of fracture, bone quality, comorbid background and previous level of physi-cal activity. A multidisciplinary approach and outpatient monitoring until recovery of physical activity as an integral part of the treatment of this group of patients.