Background: Allergic contact Dermatitis® (ACD) in older adults (OA) represents a significant health burden, but few studies examine the prevalence and characteristics of contact allergy and ACD in this population. Objective: To compare positive and clinically relevant patch test results in OA versus younger adults (YA) and children. Methods: Retrospective analysis of patch test results obtained in OA ( ≥ 65 years), YA (19-64 years), and children ( ≤ 18 years) by the North American Contact Dermatitis® Group, 2009 to 2020. Results: Of 28,177 patients patch tested, 5366 (19.0%) were OA. OA were more likely to have a final primary diagnosis of ACD as compared with YA (50.8% vs 49.2%, P = 0.035) and children (44.6%, P < 0.0001). The primary site of Dermatitis® also differed by age group, with OA having a higher proportion of Dermatitis® affecting the trunk, scalp, anogenital region, and "under clothing," and a lower proportion of Dermatitis® affecting the face, lips, and feet. Limitations: Retrospective design, lack of follow-up, and referral population. Conclusion: OA were as likely and were statistically even more likely to have a final primary diagnosis of ACD compared with YA and children. Anatomic site of Dermatitis® also differed by age group. This underscores the need for patch testing in OA when ACD is suspected.