The aim of the study was to investigate functional outcomes and perceptions of quality of life in a series of elderly patients who have sustained tibial plateau fractures. A retrospective survey of all patients aged over 60 years who were admitted to Wellington and Hutt hospitals for treatment of a tibial plateau fracture between July 1996 and December 2000 was carried out. Patients were sent the Oxford 12 knee score and the Nottingham Health profile (NHP) by mail. Radiographs were reviewed to confirm fracture type and medical notes reviewed to ascertain treatment. Patients were divided into non-operative (plaster cast or brace; n=8) and operative treatment (open reduction and internal fixation (ORIF) or total knee replacement; n=15) groups. Of 42 eligible patients, 23 returned completed questionnaires (rr=55%). The mean age of patients was 73.6 years with 16 (69.6%) females and 7 (30.4%) males. Mean time to follow up was 38.7 +/−14.5 months. The mean Oxford 12 knee score was 39.3. The mean NHP-part I scores were 17.6, 8.4, 3.3, 14.4, 2.9, 9.3 for energy level, pain, emotional reaction, sleep, social isolation and physical mobility respectively. 73% of the patients felt that their present state of health was not causing problems with any of the activities mentioned in the NHP-part II. The perceptions of outcomes of tibial plateau fractures in the elderly after conservative treatment is comparable with operative treatment. The results show Oxford 12 Knee and NHP scores similar to other studies and indicate satisfactory knee function.