The speed at which Korean Society is becoming an aging society is accelerating. Along with the increase in life expectancy, prevalence rate of diabetes is also increasing. According to the fact sheet that was published by the KDA, diabetes is one of the top 5 chronic diseases and about 29.8% of the elderly over 65 years old suffers diabetes. This leads to lower quality of life and more financial burden. There are some elements to consider in diabetes treatment of the elderly. The importance of setting individualized target HbA1c according to patient’s accompanying disease, life expectancy, duration of the disease has been emphasized. The elderly have higher risk of hypoglycemia compared to the young and drug-drug interaction should be seriously considered. Vildagliptin was the first DPP4-i in class to start clinical research in 1999. Insurance payment of Vildagliptin started in February 2009 and it has accumulated prescription data for 10 years. Data published in Lancet 2013 shows that it achieved 52.6% target HbA1c goal rate. In addition, it has proven data of increasing glucagon level compared to placebo by 38% as shown in the clamp clinical study. It does not secrete through CYP 450 and is safe from drug-drug interaction. It can be safely prescribed to formerly mentioned elderly diabetes patients.