This report is the fourth in a series on hospitalisations due to falls by Australians aged 65 and older. It focuses on 2007-08 and includes estimates of the cost to the hospital system due to serious falls. As in the previous reports, most falls were sustained by females. About one-third of all cases were for injuries to the hip and thigh, and a fall on the same level due to slipping, tripping and stumbling was the most common cause of hospitalisation. Acute admitted patient care due to fall injuries in 2007-08 was estimated to have cost more than $648 million.