Age is an independent risk factor for mortality even if all known comorbidities are considered. Thus, other factors may additionally contribute to the age-associated risk. We performed a systematic literature search and identified161 manuscripts, of which 32 studies (18256 patients) were analyzed. Cross-clamp time correlated with observed mortality. The increase in mortality risk with cross-clamp time was much greater in older compared to younger patients. The log OR for age and cross-clamp time were 0.07 and 0.01, respectively, which was highly significant for both independent risk factors. Conclusion: Age accelerates the increase in mortality risk with increasing aortic cross-clamp times.