Ageing alters physiology, pharmacology, and is associated with increased comorbidities. Reduced cardiovascular and respiratory adaptability, as well as metabolic and pharmacokinetic differences necessitates dose reduction of anaesthetic and analgesic agents. Combined with a higher number of comorbidities and likelihood of polypharmacy, this places the elderly at a higher risk for perioperative mortality. As the number of elderly patients continues to increase, special attention must therefore be paid to the altered anaesthetic requirements in this population. A thorough medical history and targeted laboratory investigations will help to ensure safe anaesthesia delivery and improved perioperative outcomes.