Although approximately half of the patients with newly diagnosed prostate or bladder cancer are older than the age of 70 years at the time of diagnosis, the literature dealing with the specific problems in this group of patients is limited. More than age alone, existing comorbidity and the patient's preference determine whether radical (curative) treatment is to be applied or whether the therapeutic aims mainly have to be palliative (relief and prophylaxis of distressing symptoms). Small-field radiotherapy, even given at high doses, seems to be an appropriate alternative to radical surgery in many elderly patients, whereas intensive chemotherapy appears less well tolerated in the majority of patients. Only very few reports have dealt with the specific problems in elderly patients with renal cell carcinoma or testicular cancer. In general, more efforts should be undertaken to increase our understanding of the epidemiologic, preventive, and therapeutic problems in elderly patients with urologic cancer.