Pediculosis, caused by infestations of head, body, or pubic lice, is a prevalent condition in the geriatric population, particularly in long-term care settings. Higher risk involves factors such as reduced personal hygiene, compromised immune systems, and close communal living. This chapter discusses the management of pediculosis in older adults, emphasizing non-pharmacological and pharmacological approaches, and preventive strategies to minimize transmission and recurrence. Non-pharmacological management is crucial for older adults who experience adverse effects from pharmacological treatments. For pediculosis pubis, partner examination and treatment are essential to prevent reinfection. Pharmacological treatments, such as topical agents (permethrin, malathion, spinosad, and ivermectin), are effective but must be used cautiously in the old, considering factors like skin sensitivity, drug interactions, and comorbid conditions. Oral ivermectin is a second-line option for more resistant cases. Complications, though rare, include secondary bacterial infections and the transmission of louse-borne pathogens, which can be more severe in those with weakened immune systems. Preventive efforts, including patient and caregiver education, play a vital role in reducing infestations and spread.