This paper describes a pilot study, in a small sample of elderly patients, designed to ascertain their perceptions of their spiritual needs and care. According to the nursing literature, spiritual care is part of the nurse's role. But it is not clear what spiritual needs are or how nurses are expected to give spiritual care. Ten patients from a care of the elderly assessment unit located in a hospital in Edinburgh, Scotland were interviewed about their spiritual needs in the summer of 1995. Eight patients admitted to having experienced spiritual needs at some time in their lives, six while in hospital. The types of needs experienced related to religion, meaning, love and belonging, morality, and death and dying. Their spiritual needs could have been better met if, for example, a quiet room for reflection/prayer had been available and if they had been told about hospital church services and provided with transport to attend. Although limited, the findings contribute to our understanding of spiritual need and spiritual care from the elderly in-patients' view point. Further research, however, is needed to explore the type of spiritual help other elderly patients and other patient groups in different geographical locations feel they would like.