The goal of podiatric surgery in the older patient should be pain management with the highest degree of functional restoration. Thorough preoperative analysis, meticulous surgical technique, and careful postoperative planning are necessary to ensure a favorable surgical result. Each planned procedure must coincide with the specific needs of the individual patient while conforming to the body's physical limitations. A complete medical examination with laboratory studies is indicated due to the elderly patient's inherent diminished physical status. When the patient is deemed a proper candidate for surgery, the medical team, family, and friends should be consulted regarding immediate and long-term postoperative care. Strict adherence to these principles is in the best interest of both the practitioner and the older patient.