A rapid rise in the prevalence of cardiovascular disease and depression has been seen in the elderly in recent years. Depression in elderly patients with cardiovascular disease is common, but features insidious occurrence, a long course, and difficulty to cure. Depression has been linked to the onset, progression, and outcome of cardiovascular disease in the elderly. The two conditions may interact through mechanisms such as disruption of the hypothalamus-pituitary-adrenal axis/autonomic nervous system,endothelial cell dysfunction, platelet activation, and inflammation. Despite limited evidence for antidepressant treatment in the elderly patients with cardiovascular disease, pharmacologic or nonpharmacological strategies for depression confer benefits.