Geriatric failure to thrive may be caused by a single medical condition but in most cases, there are multiple issues, some treatable and some not. Identifying this syndrome is challenging and often clinicians will confuse failure to thrive with the normal aging process. However, they are very different conditions and it's critical for failure to thrive to be appropriately diagnosed for a correct prognosis and treatment to be determined. The hallmarks of geriatric failure to thrive are cognitive impairment, depression, impaired physical functioning, and malnutrition. Treatment is individualized and a multi-disciplinary team approach provides the best chance for success.