The number of elderly patients is steadily increasing due to demographic changes within the population. Elderly patients have not been included in most clinical trials resulting in a lack of evidence for the appropriate treatment of this age group. In our retrospective study, we analyzed if patients > 75 years harbouring a glioblastoma or a meningioma should be treated in the same way as younger patients and if the number and severity of complications are different between both age groups. A total of 105 patients with glioblastoma or meningioma and > 75 years at the time of first operation were compared with 97 glioblastoma or meningioma patients < 50 years. Initial general and neurological conditions were worse in the elderly group. Complications associated with surgery were equally distributed between both age groups. The numbers of mood and drive disorders were higher in the elderly group resulting in temporary need for care. Glioblastoma were treated less aggressively and less frequently with adjuvant chemo- and/or radiotherapy than in the younger group, which was associated with a significantly worse overall survival. These data suggest that elderly patients might be neurosurgically treated like younger patients and prospective studies have to evaluate whether age-adjusted, more aggressive therapy regimes might be suitable for elderly glioma patients to improve particularly their grim prognosis.