The elderly are the most rapidly growing segment of our population, and onset of epilepsy is higher in this age group than in any other. With advancing age, there are changes in drug absorption, disposition, and binding. In addition, within the elderly are subgroups: (1) elderly healthy except for epilepsy (EH) and (2) elderly with multiple medical problems (EMMP). This review examines the factors that need to be considered when selecting the appropriate antiepileptic drug (AED) for an elderly person with epilepsy. Both the older and newer AEDs are reviewed.