Aging trends in India and the world over are burdening society with the health care and economic problems resulting from an older population. With this in mind, countries are preparing themselves to face the challenges of meeting this burden. India with its huge population and improving life-expectancy should be no exception. The task involves preparation in healthcare to take care of the elderly and train a new generation of physicians in geriatric medicine. The review attempts to address some of these issues and makes pertinent recommendations, based on the author's own experiences in developing a large geriatric program with all necessary components in the last decade.