Depression in people older than 65 years has a high prevalence and a negative impact on quality of life. Among the risk factors for this are: bereavement, sleep disturbance, disability, prior depressive episode, female gender, dementia and chronic medical conditions. The depressed elderly show less sad mood, more anxiety and somatic complaints that depressed young patients. The prognosis is generally poor, because the disorder in the elderly has increased relapse rate, increased risk of death from suicide and overall mortality compared with people of other ages. Also is frequent comorbidity with other medical illnesses and with other psychiatric disorders, which further dims the prognosis. The selection of drug treatment requires the individualization of patient, beware of their associated medical conditions, possible drug interactions and careful evaluation of the adverse effect profile. This article is a literature review focusing on clinical aspects concerning epidemiology, diagnosis, prognosis and treatment of this disorder, for which an electronic consultation was done in Medline and Lilacs.