The geriatric frailty syndrome can be characterised by a loss of physiological reserve in a variety of organ systems and an independent association with disability and mortality. The high cost of this condition in terms of decreased quality of life and an increased need for medical and personal care makes it an important focus for the development of effective pharmacological treatments. Several of these treatments have been trialled and have focused on the decreased levels of catabolic hormones seen in advancing age. Despite some improvement in muscle and tissue bulk, most of these treatments have failed to improve physical function in the elderly. In this review we examine the evidence for the pharmacological treatment of frailty in the elderly and provide recommendations for its management.