Objective: To explore the understanding about and perceptions of, multidisciplinary case conferencing in residential aged care from the perspective of residential facility staff, residents, carers and general practitioners.Methods: Focus groups and in-depth interviews were conducted with nurses, residents, carers, allied health workers and general practitioners from two residential aged care facilities during February-March 2008. Conversations were analysed using thematic analysis techniques.Results: Thematic analyses highlighted four key themes. Most notably, respondents identified a degree of confusion regarding the purpose of case conferencing and its role in resident health care. The ad hoc development of the conferencing model led to unclear role descriptions for participants that contributed to role confusion and the lack of a collaborative culture. Underpinning much of the discussion was the need for a framework to support the organisation of the conference process. Conclusions:While the process of multidisciplinary case conferencing in residential aged care has significant potential to improve resident care and health outcomes, the development of an explicit framework is required to support the effective conduct of these meetings. Key stakeholders need to be engaged to develop a team approach to conducting case conferences that facilitates the active participation of providers, residents and CURRENT PROJECTIONS OF population ageing in Australia predict an increase from 1.3 million Australians aged over 65 years in 2002, to 2.2 million Australians aged over 65 years by 2020. 1 The increase in those aged over 85 years is projected to nearly double over this period. 1 Current reports suggest that some 6% of Australians aged over 65 years live in residential aged care facilities, with 29.5% of those aged over 85 years requiring residential care or an aged care support package. 2 If current trends in rising chronic and complex disease remain unchanged, the ageing of the population will significantly increase the demand for residential aged care