This chapter aims to establish a stepwise workflow for the applications of musculoskeletal diagnostic imaging in elderly patients, describe some of the clinical peculiarities of old age, and suggest some specific imaging modalities relevant to the elderly. Three diagnostic imaging algorithms, covering axial trauma, appendicular skeletal trauma, and nontraumatic skeletal diseases, respectively, aim to assist the clinician in sorting through the possible differential diagnoses and, if possible, arrive at the correct diagnosis. Obtaining an early diagnosis and aggressive intervention can decrease mortality and facilitate elderly patients’ return to independent living.