With the elderly segment of the population quickly becoming the fastest growing in the world, and aging baby-boomers increasing the healthcare burden in the United States, pain clinicians are encouraged to familiarize themselves with relevant pain issues affecting the aging and to be ready to face the challenges ahead. This review enumerates some of the physical and mental changes that occur in those age 65 and over through clinical examples and offers recommendations for assessment and management of comorbid pain conditions in this population. For the purposes of this article, pathophysiologic and pharmacologic modalities will not be discussed.