Older patients pose special challenges under anesthesia because of comorbid conditions, changing pharmacokinetics, and greater susceptibility to complications. Anesthesia plans should be tailored, monitoring meticulous, and perioperative optimization important. Multimodal analgesia, minimally invasive surgical techniques, and geriatric-specific protocols minimize risks, facilitate recovery, and optimize quality of life. Multi-disciplinary care ensures older patients experience safe and effective surgery.