Polypharmacy, while often necessary in the management of complex geriatric conditions, has been associated with adverse outcomes including delirium, falls, cognitive impairment, and increased healthcare utilization. This chapter explores the concept of deprescribing—systematically reducing doses or stopping medications that may no longer be beneficial or may be causing harm. It outlines the rationale behind deprescribing in older adults and highlights clinical scenarios where it may be particularly useful, such as in patients with dementia, recurrent falls, or with high medication burden. Special attention is given to the pathophysiology and drug classes linked to delirium and fall risk. The chapter also reviews commonly used tools like deprescribing.org , Medstopper, and the AGS Beers Criteria®, which support clinicians in identifying potentially inappropriate medications. Non-pharmacologic alternatives for conditions like insomnia and chronic pain are discussed as adjuncts. Lastly, it addresses the barriers to deprescribing and emphasizes the importance of shared decision-making, interprofessional collaboration, and individualized care plans in successfully implementing deprescribing in clinical practice.