Introduction: The 24 h telephone health information and advice service in England and Wales, NHS Direct, aims to help callers manage health problems and relieve pressure on primary healthcare services. Although older people may use NHS Direct less than other age groups, no research has specifically investigated older people's use of the service. Aims: The aim of this study was to describe the older people's use of NHS Direct and to explore differences in the use of NHS Direct among subgroups of older people. Methods: A cross-sectional exploratory descriptive design utilising quantitative methods was adopted. Data on all calls made to NHS Direct by, or on behalf of, people aged 65 and over between 1 December 2007 and 30 November 2008 were analysed. Results: A total of 402,959 telephone calls were made to NHS-Direct regarding older people during the 12-month study period. The call rate was higher among women and in older age groups. Most calls were regarding actual symptoms, e.g. pain, digestive problems. Conclusions: This research identifies the characteristics of calls made to NHS Direct relating to older people and how they use the service. This will help with the planning and development of services to meet the needs of the older population.