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In the elderly, particularly those over 80 years old, head injuries often occur as a result of falls. The majority suffer from mild head injury. After clarification of the initial symptoms in these patients, the main aim is to recognize or exclude intracranial injuries (bleeding). Demonstration of intracranial bleeding is possible with cranial computed tomography (CCT), which in contrast to magnetic resonance imaging (MRI) can be quickly carried out in most cases; however, most patients with mild head injury show no intracranial bleeding. The performance of CCT and the often necessary hospital admission place a severe physical and psychological burden on the elderly. The plasma parameter S100B, combined with the clinical findings, is a valuable instrument for decision making in the management of elderly patients with mild head injury.