This issue of Anesthesiology Clinics prepares the anesthesiologist for the most challenging problems he will face with geriatric patients. Topics covered include delirium, postoperative cognitive dysfunction, fat embolism during hip replacement, Parkinson's disease and deep brain stimulator placement, diastolic dysfunction, atrial fibrillation, delayed arousal, severe atrial stenosis, multiple medications, informed consent and the ethical management of the older patient, dead bowel, acute perioperative beta-blockade in the older patient, urinary retention, and anesthetic care for patients with skin breakdown.