Objective - to identify the clinical features of inflammatory bowel disease (IBD) in elderly and senile patients in St. Petersburg. A retrospective analysis of medical charts of 208 patients over 60 years old with inflammatory bowel diseases (IBD) was carried out: 60% of them with ulcerative colitis (UC), 40% with Crohn's disease (CD). The control group consisted of 867 patients aged up to 60 years (UC- 524 patients, 60,4%; CD - 343 patients, 29,6%). Concomitant cardiovascular diseases were detected in 87% of patients, broncho-pulmonary - in 25%, diseases of the bones and joints - in 35%, pathology of the kidneys and urinary tract - in 26,5%, and liver - in 44%. Debut and recurrent IBD were often accompanied (33,6%) by a worsening of somatic pathology (versus 8,7% in other age groups of patients). It's took longer to verify diagnosis of IBD in older patients, than in patients of young and middle ages. Patients with distal localization of the pathological process (proctitis and left-sided colitis) prevailed among patients with UC, the inflammatory form of the disease dominated in patients with CD.