In this essay, the prevalence, negative health implications, and clinical management of geriatric anxiety are reviewed. Despite disproportionately high rates of anxiety amongst the elderly, little research effort has been directed at this problem. An interactive model of geriatric anxiety is proposed, whereby physical disease and anxiety processes enter into reciprocal stimulation as a function of 1) diminished capacity to withstand stress, and 2) hypervigilance of stress symptomatology. To date, pharmacotherapy has been virtually the sole approach to managing geriatric anxiety, although special hazards accrue to the elderly when anxiolytics are used. Potentially useful psychological treatments including relaxation, cognitive restructuring, activity structuring, and prevention are outlined. It is concluded that the potential human and financial rewards of increased understanding and control or geriatric anxiety are substantial.