As the number of older adults continues to increase, the population at risk for neurologic illnesses also rises. Acute and chronic seizures are commonly seen in adults older than 60 years; however, no consensus exists on the best way to diagnose and treat seizures and epilepsy in this age group. Several new medical and surgical therapies are now available for all epilepsy patients, some of which may be especially helpful for older patients. This article reviews the current literature on the diagnosis and management of seizures in older adults. Unique aspects of the epidemiology, etiology, diagnosis, and medical and surgical treatments of acute and chronic seizures in patients older than 60 years are discussed.