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Study objective To assess the association of patient and organisational factors with emergency department length of stay (ED-LOS) in elderly ED patients (226565 years old) and in younger patients (<65 years old). Methods A retrospective cohort study of internal medicine patients visiting the emergency depart-ment between September 1st 2010 and August 31st 2011 was performed. All emergency department visits by internal medicine patients 226565 years old and a random sample of internal medicine patients <65 years old were included. Organisational factors were defined as non-medical factors. ED-LOS is defined as the time between ED arrival and ED dis-charge or admission. Prolonged ED-LOS is defined as75th percentile of ED-LOS in the study population, which was 208 minutes. Results Data on 1782 emergency department visits by elderly patients and 597 emergency depart-ment visits by younger patients were analysed. Prolonged ED-LOS in elderly patients was associated with three organisational factors:>1 consultation during the emergency depart