Aging leads to measurable physiological changes in tissues and organs. Surgery in the elderly carries higher risks, with emergency procedures having mortality rates up to 80% compared to 20-25% for elective surgery. Many body systems decline with age, including reduced cardiac and lung function, decreased liver and kidney function, lower metabolism and body composition changes like loss of muscle mass. Pharmacokinetics are also altered in elderly patients, who often take multiple medications and are more susceptible to drug interactions and side effects. Thorough preoperative evaluation and postoperative monitoring are important to address age-related medical conditions and optimize outcomes for geriatric surgery patients.