The elderly population represents a relevant proportion of patients with non-ST-elevation acute coronary syndromes and are at increased risk because of the greater extent of coronary artery disease, a reduction in left ventricular ejection fraction, and associated comorbidities. Results from registries and post-hoc analysis of randomized clinical trials have shown that an early invasive strategy with myocardial revascularization when indicated offers a greater clinical benefit in the elderly that in younger patients despite an increased procedural risk in elderly patients.