Background: Allergic contact dermatitis (ACD) is a significant health problem in older adults. Reports in the literature regarding the prevalence of ACD in older adults are various and inconsistent. In contrast, the data regarding contact irritant dermatitis are more consistent. Objective: To compare ACD characteristics in older adults versus the adult population aged 18-45 years. Methods: We conducted a retrospective controlled study. Data were obtained from the medical records of 4199 patients. We collected information regarding age, gender, atopic diathesis, anatomical distribution of the rash, reactions to patch tests, and final diagnosis. Results: The frequency of positive reactions in patch testing was lower in the older adult group than in the younger population, but the frequency of clinically relevant positive reactions was higher in the older adults. There was no statistically significant difference in the final diagnosis of ACD between the groups. The most common allergens among the older adult population were fragrance mix, preservatives (Methylchloroisothiazolinone/methylisothiazolinone [MCI/MI]), and nickel sulfate. Conclusion: This study, the first of its kind in Israel to include a large group of older adult patients, contributes to a better understanding of clinical parameters related to ACD among older adults. Consequently, it will hopefully contribute to lowering the disease burden.