This study examined the relationship between age at first gambling experience and severity of gambling and related problems among older adult problem gamblers. Fifty-two problem gamblers over the age of 65 years completed self-report instruments that assessed gambling problems as well as the Short Form 36 health survey. The median age at first gambling experience was 21 years. Compared with gamblers who had a late onset of gambling, those with an early onset wagered more frequently and had more severe medical and psychiatric problems. These data suggest that gambling that begins in adolescence may be associated with an elevated severity of problems throughout the life span among older adult problem gamblers.