Background: Classical Hodgkin lymphoma occurs in 20% of patients aged over 60 years. Survival rates for elderly patients with Hodgkin Lymphoma (eHL) are disproportionately inferior compared with younger patients. In eHL poor outcome is related with biologically more aggressive disease, treatment toxicity and comorbidities. Although ABVD is regarded as standard of care for most eHL patients, adjusted treatment strategies are lacking for this particular population and innovative approaches are awaited. Aims: Characterize an elderly population with HL and analyze the impact of different treatment approaches (response to treatment, long-term outcome and occurrence of secondary neoplasms). Methods: We performed a retrospective analysis of elderly patients with HL (≥60 years) treated between 1991 and 2015, in a tertiary center. Results: Forty-six eHL patients were considered, mainly males (58.7%) with a median age of 70 years (60-80). The most prevalent histological subtype was nodular sclerosis (n=30; 65.2%). Ann Arbor stage III/IV was observed in 31 patients (67.4%), B symptoms in 34 (73.9%) and bulky disease in 2 (4.3%). The risk stratification (GHSG) was: limited n=4 (8.7%), intermediate n=10 (21.7%) and advanced n=32 (69.6%). ABVD was performed in 19 patients (41.3%); MOPP/MOPP like in 11(23.9%); other regimens in 8 (21.7%) and radiation alone in 2. Six patients had an early death event before starting chemotherapy. Overall response rate (ORR) was 72.5% (complete response - CR 67.5%); with ABVD, ORR was 73.7% (all with CR). With a median follow-up of 34.6 months (0.3-273.4), 5-year overall survival (OS) and progression free survival (PFS) were 46.1% and 35.9%, respectively. Among 33 patients who died, 20 were due to HL. Median OS and PFS were superior in patients treated with ABVD when compared with other approaches (156.6 vs 22.5 months, p=0.047 and 156.6 vs 20.3 months, p=0.035). Using a univariate analysis most International Prognostic Score factors didn’t show prognostic value, although multivariate analysis identified hemoglobin as a predictive factor of OS (HR 0.59; 95%CI 0.40-0.87, p=0.007) and PFS (HR 0.11; 95%CI 0.45-0.90, p=0.011). Four patients presented late second malignant neoplasms (n=2, ABVD; n= 2, other regimens). Conclusion: ABVD remains a standard of care in eHL. In our cohort we observed that this regimen was effective and can improve survival. We concluded that hemoglobin level is an independent predictor of survival in this population.