In Korea, about 40% of the hypertension population is the elderly and it is increasing further. Blood pressure control rate in the elderly is about 60% that is better than in the younger population. But the criteria for the optimal blood pressure control is rapidly chnaging in the elderly recently. Problems of target blood pressure in the elderly are those contradictions that are frequently encountered in the real world clinical practice. First, the higher efficacious antihypertensive treatment with low NNT is frequently underused because of the concerns regarding the risk of fall, frailty, poor renal function, polypharmacy, cognitive impairment, and more side effects. Second, there are significant gaps between chronological versus biological age in some patients. Third, target blood pressures are different among the comorbidities in a patient that make it very difficult to choose the target blood pressure to be achieved. Framework for discussion to deal with those problems and clinical algorithm to choose target blood pressure are urgently needed. For successful approaches, multidisciplinary collaboration and discussions are essential.