Abstract: Multiple organ failure in the elderly （MOFE） is a new cilinical syndrome different from multiple organ failure （MOF） caused by trauma occurring most often in young and mid-aged persons. The authors retrospectiverly analysed 158 cases of MOFE hospitalized in the past 12 years and commented on its definition, diagnostic criteria, clinical patterns and stages. The suggested definition of MOFE is the sequential occurrence of 2 or more organs failure within a short period in the elderly patients（≥60 years old） with multiple organ chronic diseases in the presence of aging of organs and age related malfunction. The most common precipitating factors are pulmonary infection and acute attack of chronic cardiac, cerebral or renal diseases. The interval between failures of various organs is mostly less than 10 days and seldom longer than 1 month. Usually, MOFE has 3 different patterns: rapid pattern with single phase; delayed pattern with two phases and recurrent pattern with multiple phases. In the last pattern the patients often suffer from multiple attacks of multiple organ failures. This pattern is only seen in MOFE, but not in MOF. The presentation of this particular pattern is related to the following facts:（1）A few organs, or only heart and lungs, are involved; （2）Kidney, brain and hemopoetic system etc, usually with poor prognosis, are not involved; （3）The age of patients are relatively younger; （4）More resuscitation experiences have been accumulated aed better suscitation measures are available. The clinical course of MOFE can be divided into 3 stages: prefailure stage （stage Ⅰ）, failure compensation stage （stage Ⅱ） and decompensation stage （stage Ⅲ）. Some problems about the dignostic criteria and the characterstics of diffent patterns and stages have also been discussed.