For more than a decade shoplifting first offenses by people over the age of 60 have been increasing. Because elderly shoplifters are usually not motivated to steal by economic hardship, their shoplifting may be symptomatic of a psychiatric disorder. The diagnostic criteria for kleptomania are summarized, and four cases of elderly patients whose shoplifting was a factor in their psychiatric diagnoses are presented. Multidimensional psychiatric evaluation of elderly first offenders is recommended and should take into account psychodynamic and neurobehavioral factors, as well as the psychiatric sequelae of the trauma of arrest and criminal processing.