© 2017 Wolters Kluwer Health, Inc. All rights reserved. Objectives: To examine the characteristics of high-energy geriatric trauma over time. Design: Retrospective chart review. Setting: Level 1 trauma center. Patients: Demographic, injury, and clinical characteristics were compared between 34,017 patients with geriatric and nongeriatric high-energy trauma from 2005 to 2014 using t test, χ 2 analysis, and negative binomial regression for annual trend in injuries. Results: Geriatric high-energy trauma composed 11.2% of all trauma activations. Patients with geriatric high-energy trauma nearly doubled from the study period of 2005-2014 to previous 10 years (P = 0.0004). Compared with patients with nongeriatric trauma, geriatric high-energy traumas were twice as likely to be due to a fall from height (P < 0.0001), had higher Injury Severity Scores (P < 0.0001), fewer abdominal injuries (P = 0.0011), and have head trauma (P < 0.0001). Fracture patterns were similar between groups. Mortality was higher for all geriatric patients (odds ratio [OR], 4.76; 95% confidence interval [CI], 4.00-5.67), and high-energy mechanisms (OR, 4.71; 95% CI, 3.90-5.68) compared with low-energy mechanisms (OR, 3.00; 95% CI, 2.48-3.62). Conclusion: The number of geriatric high-energy traumas has doubled over 10 years. Patients with geriatric trauma are sicker on presentation, based on the Injury Severity Score, and high-energy geriatrics have a 4-fold increase in mortality.