The older adult (age ≥65 years) population is a large and rapidly growing segment of the US population. EMS must prepare for a significant increase in the number of older adult patients requesting assistance. By 2030, EMS will likely transport 12 million older adults per year, and older adults will comprise approximately half of the EMS call volume. Here we discuss the changes with normal aging, assessment of the geriatric patient, medical and trauma conditions, social emergencies, public health considerations, and research. By using these general concepts, medical directors, EMS physicians, and field providers can maximize the care and health of older patients.