Summary: Proton pump inhibitors (PPI) are widely used in the treatment of gastric acid-related diseases. These drugs have become one of the most commonly prescribed drugs in primary or specialty care. Moreover they are frequently prescribed for inappropriate indications. Inappropriate PPI use is a especially essential in the elderly, who are often affected by multiple comorbidities and are taking multiple medications, and are thus at an increased risk of long-term PPI-related adverse outcomes as well as drug-to-drug interactions. It is important to administer PPI only for patients who will gain a substantial clinical benefit and to continue monitoring of their adverse effects. Older adults should be periodically evaluated for the need for continued use of PPI therapy.