Pressure ulcers are highly prevalent in older adults with restricted mobility and inflict significant burden to the patient, family, and the economy. A basic step is to identify individuals at risk and implement prevention strategies such as frequent repositioning, pressure-relieving surfaces, adequate nutrition, and skin care. Once pressure wounds develop, they can be challenging to treat. Timely repositioning and support surfaces help off-load areas but require much human and other resources. Adequate nutritional support, fluids, and control of infection are supplements to application of appropriate dressings. Debridement is the first step for wound bed preparation and entails removal of necrotic debris to allow healthy tissue to grow in its place. Specialized dressings, infused with active compounds, may be applied to the wound bed. Surgery is reserved for patients with large non-healing stage 3 or 4 ulcers. Skin flaps and grafts maybe employed to seal the pressure ulcer defect. Multiple newer modalities have emerged to assist wound management, including negative pressure wound therapy, ultrasound, laser, stem cell, and hyperbaric oxygen therapy; they are used in conjunction with conventional therapies to augment the overall effect. However, the primary goal is to prevent pressure ulcers from occurring; prevention is better than cure.