- Background There are few data regarding epidemiology and clinical features of urticarial diseases in the elderly population. Objective The aim of the study was to determine the clinical and laboratory characteristics of chronic idiopathic urticaria (CIU) in the geriatric population. Methods Electronic medical records of outpatient allergy consultations due to a diagnosis of CIU were retrospectively reviewed to collect demographic data, urticaria activity score, results of autologous serum skin test (ASST), and laboratory workup. Results From 1598 patients with chronic urticaria, there were 1319 (82.5%) adult (adult CIU group) and 124 (9.4%) elderly subjects (elderly CIU group). The elderly CIU group was characterized by lower prevalence (46.7%) of women compared to the adult CIU group (69.2%; P = 0.022); fewer wheals (1.4 ± 0.5) vs. (2.3 ± 0.7; P < 0.001); lower rates of concomitant symptomatic dermographism 2 (2.2%) vs. 121 (12.6%; P = 0.003); and lower rates of angioedema, 3 (14.1%) vs. 362 (37.8%; P < 0.001). Fewer elderly patients with CIU (18.1%) than adult patients with CIU (44.7%; P = 0.019) demonstrated a positive ASST. There were no differences in laboratory data between the study groups. Conclusion CIU in the elderly population is nearly equally distributed in both sexes and is characterized by fewer wheals, lower rates of concomitant symptomatic dermographism, lower rates of angioedema, and lower ASST positivity.