In recent years, malnutrition has become recognized as a widespread phenomenon with significant potential for complicating the course of medical treatment and compromising quality of life for hospitalized patients, many of whom are elderly. Added to this has been a heightened awareness of the needs of the institutionalized geriatric segment of our population. This group is now acknowledged as being at significant risk for nutritionally related morbidity as a result of advanced age, chronic or underlying disease, multiple drug therapy, and/or a host of social, psychological, and economic factors. The questions arise of how to identify those at risk, define the extent of their nutritional problems, and then how to best address their needs in a safe and effective manner. Recent technological advances in parenteral and enteral nutrition coupled with increasing clinical experience have greatly improved the care of the malnourished patient in the hospital, and have fostered the development of programs for outpatient nutritional management as well. Along with more sophisticated methods of providing nutritional care, various strategies are evolving for coordination and administration of nutritional assessment and support in the nation's long-term care facilities based on experience with hospitalized patients and home nutritional support programs. Clearly, there is a need for research and further attention to providing such services to these individuals. Pharmacists are now finding great professional opportunity in responding to the demand for specialized nutritional support services in this rapidly growing elderly segment of our population.