OBJECTIVE: To review the evidence that the traditional Mediterranean diet is associated with longevity. SETTING: Elderly persons of both genders in Greece, Spain, Denmark and Australia studied by different groups of investigators. METHODS: Adherence to the principles of the Mediterranean diet was operationalised through a score devised a priori, and study participants were followed up until death or the end of the study. Proportional hazard models were used. RESULTS: Closer adherence to the Mediterranean diet was associated with a significant decrease in general mortality among the elderly persons studied. CONCLUSION: The Mediterranean diet is positively associated with longevity among the elderly. If the assumption holds that there is no interaction between age and diet with respect to general mortality, it can be inferred that the traditional Mediterranean diet represents a healthy nutritional pattern.