One of the most innovative features of the Psychodynamic Diagnostic Manual, 2nd Edition (PDM-2) is its introduction of specific considerations relevant to old age. This section promotes a thorough assessment of late-life mental health, including a profile of cognitive functioning, an evaluation of personality styles and syndromes, and an analysis of the subjective experience of different symptom patterns. The manual distinguishes common, age-related difficulties from pathological impairments that reflect cognitive, behavioral, and personality problems. It helps clinicians to evaluate difficulties that frequently occur in old age—medical illnesses, affective symptoms (including suicidal ideation), functional difficulties, and problematic relationships with the environment and significant others—and gives indications for treatment. For the first time in a major diagnostic manual, the PDM-2 attempts to draw a “map” of personality patterns and syndromes in the elderly. In this brief article, we try to illuminate some central issues of psychodiagnosis with elderly patients.