In elderly patients with glioblastomas, many questions remain unresolved, including the optimal fractionation schedule for radiotherapy, the role of temozolomide as monotherapy, and the most appropriate definition of “elderly” for clinical decision-making in this setting. Based on successful phase III trials, 60 Gy involved-field radiotherapy in 30 fractions over 6 weeks [Standard radiation therapy (RT)] with concurrent and adjuvant temozolomide is currently the standard of care. In this disease, age and Karnofsky Performance Status (KPS) are the most important prognostic factors. For elderly patients, clinical trials comparing standard RT with radiotherapy abbreviated to 40 Gy in 15 fractions over 3 weeks demonstrated similar outcomes, indicating shortened radiotherapy may be an appropriate option for elderly patients. There is also evidence that temozolomide alone may be more effective than radiotherapy alone for elderly patients with methylation of the O6-methylguanine–DNA methyltransferase (MGMT) gene promoter region. Although the incidence of MGMT promoter methylation is not age-dependent, extensive data are lacking with respect to the benefit of adding temozolomide to short-course radiotherapy in elderly patients with glioblastoma and its dependence on status regarding MGMT promoter methylation in tumors (MGMT status).In elderly still many unanswered questions like Can we do away with RT altogether for patients with MGMT methylation? or Can we combine TMZ with other hypofractionated regimens such as 34 Gy/10 or 25 Gy/5 fractions? Undoubtedly, further trials will be needed to answer these questions and guide our practice.