Introduction: Little is known about falls severe enough to require hospitalization at the population level. This study assesses the current prevalence of such falls among older adults in Quebec. It examines trends over the past 15 years and discusses the use of administrative data to identify the circumstances surrounding these falls. Method: This retrospective study examines cases of hospitalization due to falls among Quebec residents aged 65 and older who were admitted between April 1991 and March 2005. Results: In Quebec, there are 13,300 falls annually resulting in hospitalization of a person aged 65 or older. This represents an average annual rate of 1,283 falls per 100,000 people; this figure masks significant differences by age and sex. While hospitalization rates have remained relatively stable over the past 15 years, the number of cases is rising rapidly due to population aging. In 90% of cases, the individual was living at home at the time of the fall. Furthermore, more than 9% of falls occurred on stairs, and information regarding the circumstances of the fall is missing in 46% of cases. Discussion: Administrative data systems are worth utilizing to track trends in fall-related morbidity at the population level. The accuracy of information regarding the circumstances of the fall must improve to be useful for research, intervention planning, and eventually for evaluating those interventions.