This article discusses the importance of polypharmacy as a growing problem in modern medicine. This issue is most prominent in elderly population, which due to changes in the structure of society, is becoming one of the most common group of patients in a GP’s office. Statistically, every patient over 65 years of age uses between 4 and 8 medications simultaneously. Adverse effects of medicinal products are responsible for over 20% of instances of hospitalization in elderly patients, out of which up to 7% lead directly or indirectly to death. The paper discusses the adverse effects and interactions between multiple drugs which pose an increasing challenge when creating an individual therapy plan for elderly patients. Though guidelines for healthcare professionals such as Beers, STOPP/START criteria or Priscus list have been created in order to facilitate drug treatment and to help improve the safety of prescribing medications for older adults, they do not exhaust all the possible difficulties encountered when dealing with elderly patients. This article presents the most important rules, specificity and challenges of polypharmacotherapy in elderly patients, including physiological metabolism changes in elderly patients, multispecialist healthcare system, lower compliance in senior patient population, easy access to OTC drugs and supplements, and common adverse effects.