AIM: To examine the relationship between atrophic glossitis (absence of papillae in more than 50% of the tongue) and nutritional status. DESIGN: A randomized population survey. SETTING: The medical department of Aker University Hospital, and people living at home. PARTICIPANTS: 310 old people recently admitted to hospital and 106 randomly selected elderly people at home. MEASURES: The presence of atrophic glossitis and nutritional indices. RESULTS: Atrophic glossitis occurred in 13.2% of men and 5.6% of women at home and in 26.6% of men and 37% of women in hospital. The atrophic glossitis was related to reduced weight, body mass index, triceps skinfold thickness, arm-muscle circumference, muscular strength, activities of daily living and serum concentrations of cholesterol, ascorbic acid, cholecalcidiol and B12, but not to levels of zinc or folate. In a multiple logistic regression model, atrophic glossitis was related only to cholesterol (P = 0.032), muscular strength (P = 0.018) and activities of daily living (P = 0.03). CONCLUSION: Atrophic glossitis is common in elderly people and is a marker for malnutrition and reduced muscle function.