Age-associated nail changes and disorders are common in elderly patients. Characteristic changes in color, contour, growth, surface, thickness, and histology occur in the nail unit as persons become older. Several onychodystrophies are frequently observed in these elderly patients: brittle nails, those induced by faulty biomechanics and trauma, infections, onychauxis, onychoclavus, onychogryphosis, onychophosis, splinter hemorrhages and subungual hematomas, and subungual exostosis. Awareness of the signs and symptoms of the aging nail will enable better assessment and management of the onychologic concerns of this group of older patients.