Allogeneic hematopoietic cell transplantation (HCT) is no longer exclusively for the young. With an aging population, development of non‐intensive remission‐inducing strategies for hematologic malignancies, and novel graft‐versus‐host disease‐prevention platforms, an older population of patients is pursuing HCT. The evolving population of HCT recipients requires an overhaul in the way we risk‐stratify and optimize patients prior to HCT. Here, we review the history and current state of HCT for older adults and propose an assessment and intervention flow to bridge the gaps in today's clinical guidelines.