SUMMARYClozapine is one of the most effective drugs available to psychiatrists for treating psychosis. It is currently licensed for use in treatment-resistant schizophrenia and psychosis in Parkinson's disease, but its use in old age psychiatry is very uncommon. With the ageing population, and the increased incidence of psychosis in older patients, it is important to consider whether this is a drug that is not being used to its full advantage.LEARNING OBJECTIVES•Appreciate the differences in titration and monitoring of clozapine in older adults, compared with working-age adults•Consider the efficacy of clozapine in older people and its impact on mortality•Understand the side-effect profile of clozapine in older adultsDECLARATION OF INTERESTNone.