Background Nigeria, with a population growth rate (2000-2005) of 2.5% and with 5% of the total population aged 60 years and above, has the potential for a rapid growth rate of the older population in coming years.1 The implication of this in a country with large population as reported by the National Population Census 2006, limited number of health care professionals and care homes, is difficulty in meeting the various needs of the elderly, hence, the importance of identifying the palliative care needs of the elderly. Aim The study was set out to assess the palliative care needs of and provision of care to elderly patients seen in the selected clinics of the University College Hospital, Ibadan, Oyo state, Nigeria. Objectives 1. To describe characteristics of elderly patients seen in the selected clinics. 2. To explore the current use of the hospital palliative care team in the care of geriatric patient. 3. To explore the current use of the hospital palliative care team in the care of geriatric patient. Methods A descriptive cross-sectional study was conducted over a 3-month period using an interviewer administered questionnaire after full consent was given by participants. The questionnaire was a combination of the Africa Palliative Care Outcome Scale (APCA-POS), the Edmonton Symptom Assessment Scale (ESAS) and Hope Spiritual Assessment Tool. Demographic information regarding gender, age, nationality, abode and referral to the Care Centre was obtained. Scaled questions from selected tools were ticked with respect to physical, psychosocial and spiritual needs and expectations of palliative care. The validated data collection tools (APCA-POS, ESAS, HOPE) were used in the questionnaire. Ethical approval was obtained from the relevant organizations. Data was analysed using IBM SPSS statistics 21. Results 424 participants completed the questionnaire and most patients (330; 77.8%) were recruited from the geriatric wards with a 2:1 female to male ratio. Most participants fell in the 60 -69 year-old age group. The most common symptom was pain in 240 patients with moderate pain in single or multiple areas. A high percentage (45.8%) were moderately worried about their disease condition and only 66 out of 422 freely discussed this feeling with their family members. Other symptoms observed were nausea, vomiting, constipation and loss of appetite. Conclusion The study showed the palliative care needs of the elderly and calls for collaboration between the palliative care team and the physicians in the geriatric unit for better management of the needs of the elderly.