Purpose: This study was done to investigate characteristics and clinical outcomes in older adults with aspiration pneumonia and to identify differences in clinical outcomes according to the general and clinical characteristics of the elders. Methods: The 2011 to 2016 emergency medical center electronic records of 138 patients aged 65 years or older with aspiration pneumonia were reviewed. Results: The major characteristics of the participants were: 75 years of age or older (72.5%), male (63.8%), neurological or cardiovascular disease (58.7%), two or more chronic diseases (71.7%), dependent walking (79.7%) and dependent eating (79.0%). In the treatment outcomes, 42% of the participants got worse or died. The hospital length of stay varied according to causes of aspiration (x2=13.35, p=.004), neoplastic disease (Z=-2.24, p=.025), and paralysis (Z=-3.08 p=.002). There were differences in intensive care unit admissions according to the number of chronic diseases (x2=6.00, p=.041) and pneumonia severity index classification (x2=17.64, p<.001). The place of residence (x2=6.85, p=.033), serum albumin (x2=6.26, p=.044), and pneumonia severity index classification (x2=10.99, p=.001) influenced the treatment outcomes. Conclusion: Older patients with the characteristics presented in this study would be classified as the aspiration pneumonia risk group and should be provided with preventive interventions.