The nonsteroidal anti-inflammatory drugs (NSAIDs) are commonly used medications, particularly in elderly patients, for both rheumatic and nonrheumatic conditions. Elderly patients are more prone to the adverse effects of these agents. Adverse effects are seen in almost every organ system, but the gastrointestinal tract is most frequently affected. Elderly patients are more at risk of adverse effects from a wide range of pharmacokinetic and pharmacodynamic interactions compared with younger patients. By cautious prescribing, including giving due consideration to these factors, the risks associated with NSAIDs in elderly patients can be minimised.