The techniques in abdominal surgery have improved by leaps and bounds in the twenty-first century, with minimally invasive surgery (MIS) now being touted almost always as the standard of care. MIS offers significant benefits such as shorter hospital stays and earlier return to function, making it an invaluable approach for a fast-growing subgroup of patients—the older persons. As the world experiences significant demographic transition toward an aging society, there is a fast-growing opportunity for MIS in older persons. In this chapter, we discuss the benefits, challenges, and perioperative considerations for the adoption of MIS in the older population.