Sarcopenia is the physiological age related decline in muscle mass and strength. The aetiology is multifactorial involving changes in muscle metabolism, endocrine changes, nutritional factors and mitochondrial & genetic factors. Various treatment modalities have been utilized including hormone replacement therapies but only high resistance training (HIRT) exercise has been of significant benefit. Despite recent advances the exact pathogenesis and therapies are not well understood and need further investigation. This paper reviews the current knowledge of aetiopathogenesis and treatments of sarcopenia and suggests future strategies to enhance the understanding of muscle aging and potential therapies.