Aspiration pneumonia is one of the important reasons of prolonged hospitalization, readmission, deteriorated to critical condition or even death in elderly in-patients. The high risk factors related to onset and prognosis of the aspirated elderly are complex and diversified, leading to a significant challenge to the clinical practice. This review summarized research progresses of the past 10 years in the field of comprehensive management of elderly in-patients with aspiration pneumonia, especially focusing on dysphagia screening, assessment and management, comprehensive geriatric assessment, multidisciplinary team intervention, as well as continuous follow-up. In combination with author′s clinical practice experience, we try to explore effective management protocols suitable for our national conditions.