In elderly patients, an isolated increase in systolic blood pressure is common and associated with increased risk factors like cardiovascular disease, cerebrovascular disease, peripheral artery disease, cognitive impairment and kidney disease. There are 5 main groups of drugs discussed which can be used in the management of hypertension in elderly, these drugs target various pathways. Thiazide diuretics such as chlorothiazide, hydrochlorothiazide, chlorthalidone, usually the first line therapy used in these patients. The drugs that work of the renin angiotensin aldosterone system, include Angiotensin converting enzyme inhibitors (ACEI), Angiotensin receptor blockers (ARBs), and direct renin inhibitors. Another class of drugs called calcium channel blockers (amlodipine,nifedipine, nicardipine, verapamil) disrupt the voltage gated L-type calcium channel. Managing blood pressure control in elderly can be quite challenging, paying attention to other comorbidities present in this age group is important.