Abstract: China’s population is aging, and cancer is an aging-related disease. The incidence of malignant tumors is generally high in the elderly. There is a fundamental link between aging and cancer. In addition, elderly patients with cancer have unique characteristics, such as comorbidities, polypharmacy, frailty, and cognitive impairment, which limit the application of conventional anti-tumor therapies in this special population. Therefore, treatment decision-making for elderly cancer patients is largely dependent on excellent dynamic geriatric assessment, which can predict whether these patients will benefit from conventional anti-tumor therapies. Furthermore, due to ethical requirements, most clinical studies set an upper age limit for enrollment. Based on this clinical evidence, clinical management of elderly patients with cancer is difficult, and innovations in this field are urgently needed. This article reviews the current research and development trends in the aforementioned area and discusses the comprehensive evaluation and accurate clinical decision-making for elderly patients with cancer.