Life expectancy has markedly increased during recent decades, resulting in a growing number of older individuals. Many of these elderly are turning to mountain sports activities in search of fun and new challenges. Although the scientific community has taken broad interest in the ageing process and how it affects physical and mental performance, little attention has focused on the elderly mountaineer. Mountain sports demand a relatively high degree of physical fitness and, because fitness and health decline with age, the risk of injury and death during mountain sports will increase. However, little information is available on fitness requirements for elderly mountaineers. This article mainly focuses on such requirements, and on performance limitations, assessment of individual performance, and training recommendations. A normal ascent rate of 300 meters per hour (up to 3500 m) requires an altitude-dependent relative oxygen consumption of 18-22 ml x min(-1) x kg(-1) or an ergometric performance of 1.2-1.5 watt x kg(-1) below the individual anaerobic threshold. Mild cardiopulmonary and musculoskeletal diseases are not contraindications for mountain sports activities, provided the proposed fitness requirements are attained. A regular exercise-training program under medical and sports expert advice will help the elderly to achieve these fitness standards, enjoy the mountain environment, and prevent injuries and fatalities.