Background: Tooth replacement service is generally available in our environment. However, its utilization by the elderly has not been extensively studied. Aim: To determine the utilization of tooth replacement services among the elderly. Materials and Methods: This was a retrospective study of 440 patients aged 60 years and above attending the prosthetic out‑patient clinics of Lagos University teaching hospital (LUTH) and Lagos state University teaching hospital (LASUTH) from January, 2008 to March, 2010. record books or case records: Age, sex, and number of teeth replaced. Results were collated and analyzed using Epi Info 2004. Values were presented as simple percentages. Results: There were 229/440 (52.0%) males and 211/440 (48.0%) females and were aged 60‑90 years with a mean age of 68.9 (6.92). A total number of 4,062 teeth were replaced. Average number of tooth replaced among the patients was 9.45 for LUTH and 8.94 for LASUTH. The maxillary anterior teeth were the most frequently replaced 1422/4062 (35.0%) and the least replaced were the mandibular posterior teeth 812/4062 (20.0%). The average number of tooth replaced generally increased with age in both sexes. A total of 90 complete maxillary and mandibular dentures were fabricated, while six single arch complete dentures were made. The remaining were partial dentures. Conclusion: The most common age of presentation is 60‑65 years. Patients that were 90 years and above appear to utilize teeth replacement facilities in this environment less than those in developed countries. Maxillary anterior teeth were the most frequently replaced.