Geriatric population is showing their great growing potential as the world is advancing everyday. Geriatric medicine has been an essential subspecialty of internal medicine, which serves the elderly better in different manners. However, this population needs more focus in other aspects of medicine. One of the important ones to develop special care and services to the elderly would be emergency medicine (EM). As EM is advancing well for the last 15 years in Malaysia, geriatric populations, whom initially were treated as old adults, are now noted as a different category with unique needs, where distinct plan should be started right from the door gate. Hence, there comes the problems, challenges and issues of geriatrics in emergency medicine. And, this will lead to one of the crucial branches of emergency medicine in Malaysia.