Late-life depression is the most common mood disorder in the geriatric population. Often encountered in the primary care setting, geriatric depression needs to be appropriately diagnosed and differentiated from medical conditions that can mimic it or present with mood symptoms. This review will help psychiatrists and primary care physicians to screen for, identify possible medical confounders, and treat depression in the elderly. Untreated major depression may lead to increased morbidity and mortality from medical illnesses, and is the strongest risk factor for late-life suicide. Pharmacological approaches should be used in combination with psychotherapies, several of which have solid evidence in geriatric depression.