Purpose of Review <p>This narrative review examines bioethical issues in geriatric kidney transplantation (KT). It highlights recent studies and reviews that explicitly discuss ethical considerations in this growing patient demographic.</p> Recent Findings <p>Formal ethical analyses are limited; however, there may be renewed interest as recent studies have shifted towards a patient-centered approach in addressing equitable access, considering pre-transplant evaluation, understanding personal and societal dynamics, and integrating successful aging in patient care. These studies emphasize the responsibility of professionals to address disparities and inequities. As medical advancements in KT continue to develop, they are poised to reshape evaluations and treatments for older adults, introducing new ethical considerations.</p> Summary <p>KT in older adults presents unique ethical challenges. Addressing biases, ensuring equitable access through fair evaluation, and acknowledging the responsibility of providers in supporting older patients are crucial for ethical practice. Continued research and formal ethics discourse are essential as medical advancements evolve.</p>