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Anaphylaxis is a potentially fatal generalized hypersensitivity reaction leading to multiorgan dysfunction. It involves multiple mediators using several different pathways for the development of a systemic response. The elderly differ from other age groups in terms of the risk factors, causative agents and the development of compensatory mechanisms. The presence of comorbidities and polypharmacy has a marked influence on treatment and outcome in the elderly. This article aims at a general understanding of anaphylaxis with special reference to the elderly.