Purpose of Review <p>The purpose was to present latest findings on factors that can help improve risk profiling for surgery in the elderly and thus improve outcomes.</p> Recent Findings <p>Approximately two thirds of patients undergoing urological surgery are elderly. A number of assessment tools are now available for clinical application to facilitate risk planning when considering surgery. There is an overall lack of trials performed in the elderly on account of a number of factors including cognitive impairment, mobility and perceived lack of benefit. Clinicians are generally poor at estimating 10-year survival in patients and usually underestimate it. Treatment success in this demographic varies from the index patient and an individualised approach should be taken.</p> Summary <p>It is of increasing relevance for clinicians to familiarize themselves with tools that can facilitate surgical care in the elderly. Prospective studies are needed, which also monitor outcomes in patients who did not undergo surgery.</p>