Delirium is one of the most common complications of hospitalized elderly people and is associated with increased mortality, institutionalization, length of stay, healthcare costs, and permanent cognitive decline. Based on the evidence, there does not appear to be an effective treatment for delirium once it develops, and most research has shifted to focus on prevention rather than treatment. Although much of the research remains inconclusive, it is clear that non-pharmacological multicomponent interventions, targeted towards addressing the multifactorial etiology of delirium, are the most effective approach to preventing delirium. Additionally, opioid sparing drug regimens with regional anesthetic blocks have proven effectiveness in preventing delirium. However, evidence regarding pharmacologic interventions for the prevention and treatment of delirium remains inconclusive and fails to show any consistent benefit or effectiveness in delirium. Besides widespread implementation of multicomponent interventions, more evidence is needed before best practice recommendations can be made to guide prevention and treatment of delirium.