Background <p>Surgeons need to master many manual skills, which potentially decrease with age. Yet, there is no standardized approach to objectively assess how aging affects basic surgical performance and skills training. In this context, simulation offers a promising solution, being widely used to train and test novice clinicians. This study aims to evaluate the impact of age on performance using a visuo-haptic surgical simulator.</p> Methods <p>A total of 39 participants were divided in two groups: 20 young (20–40 years) and 19 older adults (50–70 years). All participants completed multiple repetitions of three basic surgical tasks using a custom visuo-haptic simulator: incision, an adapted version of the needle threading task, and suturing. Performance metrics such as errors, trajectory, and task duration were compared between groups and across repetitions.</p> Results <p>Younger participants outperformed older ones in all tasks. Specifically, they cut more tissue, made fewer errors in the dexterity task, and sutured faster. Both groups partially improved with practice, although older subjects improved less than younger ones.</p> Conclusions <p>Altogether these results suggest that age significantly affects performance in basic surgical tasks; moreover, older subjects might benefit from periodic training sessions to maintain their skills. In this regard, visuo-haptic simulation can serve as an effective training and evaluation tool to assess and counteract the effects of aging on surgical ability.</p>