Physical abuse of older adults is the intentional use of physical force, including strangulation, that may result in bodily injury, physical pain or impairment. Accounting for approximately 2.6% of all types of abuse, physical abuse can have serious consequences including increased morbidity, rates of hospitalization and mortality. Perpetrators are commonly individuals close to the victim, often family members or caregivers. Risk factors for physical abuse include social isolation, low socioeconomic status, poor mental health, history of family violence, traumatic event exposure, and substance abuse. Forensic injury patterns highly specific for physical elder abuse have not yet been described, though suggestive injury patterns exist that may help professionals assessing injured older adults to distinguish between abuse and injuries from unintentional injury. Medical providers are among the only people an isolated older adult may have contact with outside of the home. It is critical that clinical professionals who work with older adults are familiar with their state reporting laws for elder mistreatment, including physical abuse, and collaborate with community agencies to provide support for victims. Physical abuse, including strangulation, may be crimes for which medical evidence and expert testimony are often critical in determining if a physical abuse case can be prosecuted. Various alternatives are available to resolve a physical abuse case which may better align with a victim’s wishes while protecting the community and holding offenders accountable. Multidisciplinary teams are critical in building, evaluating, and resolving physical abuse cases and supporting victims.