The older population, characterized by organ dysfunction and multi-morbidity, is subject to polypharmacy with associated adverse drug events, including dermatological manifestations. Cutaneous reactions to medications are common but highly variable, ranging from mild to severe, life-threatening patterns. The classification of hypersensitivity reactions with examples of several medication classes and associated dermatological adverse drug events is discussed. The pathogenesis of cutaneous adverse drug events is complex. Management involves recognizing the adverse event, relating it to a drug, withdrawing the likely offending agent, and providing supportive measures. Patch testing may have a role. Clinicians should focus on understanding the factors involved in these reactions. It is important that healthcare providers take steps to prevent the recurrence of adverse drug events in the future. Possible offending drugs must be used with caution in older people.