Introduction: Demographic transition is an epidemiological change from which Colombia is not exempt, cardiovascular disease continues to be the most frequent cause of mortality.The growing older adult population and the characteristics of aging lead to different approaches to their diseases.This population is usually excluded from clinical studies, which is why a descriptive study of the clinical and epidemiological characteristics of this age group was carried out.Objective: To carry out a descriptive study of the clinical and epidemiological characteristics of older adults hospitalized with acute coronary syndrome. Materials and method:The medical record of 92 patients over the age of 80 were reviewed.Results: A mean age of 83 years was found, 55.4% of the patients were men, invasive management was selected in 51%, the main risk factors were arterial hypertension and diabetes mellitus, and the main clinical history found was that of established coronary disease.The incidence of both complications and mortality was higher in the group which did not undergo invasive management, probably secondary to the number of comorbidities and prior complications.In addition, fragility was not described in most patients in this age group, and their pharmacological treatment did not differ from that of younger patients, according to the literature.Conclusions: Patients undergoing medical management had more complications possibly secondary to their underlying comorbidities; the patients undergoing catheterization had favorable results in terms of morbidity and mortality compared to the group that only received medical management.Comprehensive assessment of the elderly is important, since evaluating their functional and mental status helps in making decisions regarding the treatment of acute coronary syndrome.