Background: Depression among the physically ill is common and frequently under-diagnosed. Elderly patients with depressive symptoms are at higher risk of hospital admission for non psychiatric conditions and are more likely to have longer hospital stays and worse hospital outcomes, compared with non depressed patients.  Objectives: The aim of this study was to find out if depression can be considered a predictor of prolonged hospital stay in elderly patients. Design: A prospective cohort study. Participants: 205 consecutive patients 60 years and over both males and females. Settings: Ain shams university hospitals. Measurements: All participants were assessed using comprehensive geriatric assessment including Geriatric depression scale (GDS) and the length of stay was registered. Results: Depressed patients had longer length of hospital stay compared to non depressed patients and the least length of hospital stay was for cases with no risk on GDS scale compared to other groups and the difference is highly significant statistically (p=<0.001).  Conclusion: length of hospital stay is significantly longer among depressed elderly.