Epilepsy is a brain disease characterized by a permanent predisposition to seizures and the neurobiological, cognitive, psychological and social consequences of recurrent seizures, caused by abnormal excessive or synchronous neuronal activity in the cortex of the brain. It is one of the most common neurological diseases, The frequency of epilepsy increases with aging, occurs more often in males and in developing countries. Epilepsy is not a single disease, not even an individual syndrome, but rather a wide range of clinical symptoms - epileptic seizures, which can be manifested in the sensory, motor, experiential or autonomic-vegetative sphere, often with loss or disturbance of consciousness. Epilepsy may have structural, genetic, infectious, metabolic, immune or unknown etiology. Among elderly, the most common known risk factors are cerebrovascular disease, dementia, cerebral neoplasms and head trauma. There are several guidelines as well as classifications for epilepsy that are set and keep being updated by the ILAE. However, concerning the epilepsy in elderly population, the researchers are still trying to find some answers. The number of elderly population is rising in the developed part of the world, so it is a topic that needs to be addressed. A large portion of older people suffer from epilepsy of unknown onset. There is a long list of differential diagnoses possible in these individuals, so it can be easily misdiagnosed. Until now, it is known that older people are more compliant with less frequent dosing of therapy, have less adverse effects on monotherapy and should take lower doses of AEDs. The therapy in elderly patients should be individualized. Nonetheless, there are not complete guidelines regarding management of epilepsy in elderly. Many elderly also suffer from comorbidities, which further complicates the selection of therapy. With the recent development of new AEDs it opens even more possibilities. Therefore more researches need to be conducted and evidence to make the decision making easier for the physicians in selecting the optimal path of treatment.