alcohol abuse is often hidden and unrecognized problem among seniors. although the degree of the aged affected by alcohol abuse may not be extremely high, alcohol consumption appears to be particularly toxic in the elderly, claiming a very high medical and social toll. for a large number of elderly, primary care physicians are the most accessible professionals who can diagnose and treat their drinking problems. however, research indicates that physicians are not assuming the role of diagnosing, referring or treating elderly alcohol abusers with any regularity, effectiveness or enthusiasm. this study examines the issue of under-diagnosing of elderly alcohol abuse by primary care physicians, and. specifically, seeks to answer the question: what are the causes for the low recognition and treatment rate of elderly alcohol abuse by primary care physicians? twenty-eight primary care physicians practicing in thunder bay, ontario, were questioned regarding their perceptions of elderly alcohol abuse. attention was given to physicians’ subjective assessment of the prevalence. identification and treatment rate of elderly alcohol abuse in their own practices. an important part of the study was the examination of physicians’ self-perceived attitudes toward elderly alcohol abuse. the results indicate that the cause for the low recognition and treatment rate of elderly alcohol abuse by primary care physicians is multifactorial, with many of the factors being interrelated. the identified factors are: lack of training on alcohol abuse in medical schools, low attendance at continuing medical education seminars on alcohol abuse, negative attitudes toward elderly alcohol abuse, lack of time/large patient load, and existing treatment programs perceived as non-effective.