Purpose: Patients undergoing cardiac surgery are increasingly older, possessing more co-morbidities. This presents an interesting challenge for cardiac surgeons in decision making around which patients would likely do well post-operatively, especially given the limitations of traditional risk-calculators at the extremes of age. Due to current trend towards an older population, Octogenarian patients are representing a larger patient pool than ever before. This abstract seeks to describe short-term post-surgical outcomes in octogenarians undergoing cardiac surgery at a single South Australian centre between 2013-2023. Method: All patients undergoing cardiac surgery at the Royal Adelaide Hospital between 2013-2023 were extracted from the ANZSCTS database. Patients were divided into two groups – younger than 80 and 80 or older. Demographics, intra-operative and post-operative outcomes were compared between the two groups. Results: 5488 patients underwent cardiac surgery between 2013-2023. 463 (8%) were at least 80 years old, and 5025 (92%) were younger than 80. The mean age in the octogenarian group was 83 years (SD 2), whereas the mean age in the younger group was 63 years (SD 11). Octogenarians were less likely to be diabetic, p<0.01. However, octogenarians had higher rates of hypertension and cerebrovascular disease, p<0.01. In the octogenarian group, 22 patients (5%) died within 30 days of their operation, compared to 94 patients (2%) in the younger group, p<0.01. There was no statistical difference in post-operative stroke or haemofiltration. Conclusion: Our retrospective analysis demonstrates that while there was no significant difference in post-operative stroke and haemofiltration rate between the octogenarian and the younger population, 30-day mortality rate was at least double that of the younger group. This highlights the importance of careful decision making in this patient group, especially given that traditional risk calculators, may under-estimate risk for this patient population.