Drug therapies in elderly people are difficult to manage for different patient-related and drug-related factors. Hence, elderly people are prone to be prescribed with inappropriate medications. Different approaches have been developed so far to optimize the therapy in elderly people. The most widely studied and used are the explicit criteria. Results from the prospective and retrospective studies based on explicit criteria suggest a high prevalence of inappropriate prescribing in the global elderly population. Numerous predictors of inappropriate prescribing have also been identified so far however; the studies do not comply with each other. Furthermore, observational studies on health-related events associated with the inappropriate prescription in geriatrics suggest a need of timely implementation of appropriate interventions including involvement of clinical pharmacists during a drug utilization review, multidisciplinary approach for therapy optimization, continuing education to physicians, computer-based therapeutic support systems and so on.