Abstract: Elderly patients have altered physiology in systems such as the cardiovascular, respiratory, renal, digestive, and metabolic systems, which influences the pharmacokinetics and pharmacodynamics of anesthetic drugs used during surgery. The free percentage of anesthetic drugs available is also affected by variations in plasma protein concentrations in geriatric individuals. The death rate among older individuals rises after surgery due to various comorbidities which additionally impact the effect of anaesthetic drugs. Pre- or post-operation, the clinically significant parameters such as vital sign monitoring in geriatric patients, positioning, induction and maintenance doses of the anesthetic agent, and anesthesia type must be chosen carefully to optimize the perioperative care practices and better outcomes. The purpose of this narrative review is to provide current information on the effects of anesthetic agents on older patients, as well as to optimize perioperative care practices.