The epidemiological transition is characterized by changes in health and disease patterns over time. Thus, this chapter intends to reflect on the impact of the epidemiological transition on population aging, as well as the importance of physiotherapy for health promotion and disease prevention. A literature review was carried out using texts published between 1997 and 2023, in Portuguese and English with the keywords: epidemiological transition, aging, physiotherapy and elderly health. It was found, based on the literature consulted, that the increase in life expectancy must be accompanied by approaches that take into account the quality of life of these individuals, involving issues related to their health and limitations in their functioning that affect their daily actions and life goals. In this sense, the main health indicators of the elderly population must take into account their full functioning and the focus of health care must respond to real needs, such as the long-term management of chronic conditions, including, in particular, the expansion and strengthening of rehabilitation and its impact on functionality and disability. Thus, physiotherapy, as a health strategy, incorporating rehabilitation and prevention, becomes one of the main health strategies of the 21st century.