Of 92 patients with seizures beginning after the age of 60, twenty (22%) were found to have brain neoplasms and nine (10%) to have other known causes of seizures. The etiology remains unknown for 63 patients despite a follow-up period ranging from 5½ to 7½ years for 97% (61). As compared with patients having seizures of unknown etiology, patients in the tumor group exhibited a preponderance of focal findings (clinical and electroencephalographic), insidious onset of symptoms, short duration of illness, and focal extratemporal seizures. The proportion of patients with seizures caused by neoplasms declined with advancing age (28% of those in the seventh decade and 7% of patients 70 years of age or older). Despite this decline, tumor remains an important consideration for diagnosis when seizures begin after the age of 60.