Asthma is associated with significant morbidity and mortality in the geriatric population. Despite the rising incidence of asthma in people >65 years of age, the diagnosis is frequently missed in this population. Factors that contribute to this include respiratory changes caused by aging, immunosenescence, lack of symptoms, polypharmacy, clinician unawareness, and lack of evidence-based guidelines for diagnosis and management that target this population. This literature review addresses the current state of research in this area. Age-related changes influence the pathophysiology and role of allergy in elderly asthmatic patients. Specific obstacles encountered in caring for these patients are discussed. Asthma in the elderly and younger population are compared. We conclude with a broad set of goals to guide future management driven by a multidiscipline approach.