Thyroid dysfunction is common in elderly individuals, with unique diagnostic and therapeutic challenges arising from age-related physiological changes and comorbidities. Epidemiological data reveal distinct risk factors and incidence patterns in this population. Current diagnostic approaches must account for age-specific variations in thyroid function tests, while treatment strategies require careful risk-benefit assessment. Psychological and social factors significantly influence disease management. Future studies should address personalized treatment thresholds and novel therapeutic options for this aging patient group.