Background: The elderly population in Lower Silesia, Poland, faces increased vulnerability to infectious diseases due to population ageing. A comprehensive epidemiological surveillance program among seniors is crucial for effective public health planning and intervention strategies. This study aims to characterise infectious‑disease trends among individuals aged ≥65 years, emphasising the importance of tailored preventive measures. Material and Methods: This retrospective study analysed infection registries maintained by the State Sanitary Inspection 2020–2023 for people aged ≥65 years. Included registries encompassed notifiable infectious diseases (12 811 doctors’ reports and 1499 laboratory reports), hospital‑acquired infections and outbreaks, tuberculosis notifications (230 cases), influenza‑like illnesses (ILI) (104 487 suspected cases), and gastrointestinal outbreaks (46 outbreaks in facilities with seniors). Spatial and temporal variations in incidence were examined in relation to demographic changes and disease types. Results: There was a notable increase in bacterial gastrointestinal infections and ILI among the elderly, with reporting rising markedly after lockdowns. Incidence rates shifted toward older age groups. Bacterial intestinal infections, primarily caused by Clostridioides difficile, increased by approx. 54%/year. Hepatitis B and C incidence was elevated, especially in long‑term care facilities. Gastric outbreak numbers were stable, despite more notifications overall. Spa districts recorded higher infection rates than the rest of the region (1186.6 vs. 630.0/100 000 adults aged ≥65 years, p = 0.014). Notifications of sexually transmitted infections (STIs) were very rare. Conclusions: The findings highlight increased vulnerability of seniors, driven by diminished immunity and comorbidities, and underscore the need for targeted vaccination, systematic screening for STIs and other infections, and capacity building to meet rising demand for care among older patients. Spatial analyses point to higher risks in spa districts and call for more accurate surveillance of visitors. Improved digital integration of health surveillance systems will be critical for monitoring and responding to infectious threats in the elderly population. Med Pr Work Health Saf. 2026;77(4)