Abstract The combination of fludarabine, Cyclophosphamide and Rituximab (FCR) has been widely used in the treatment of lymphoproliferative disorders and it is now considered as the standard first-line therapy for fit, young patients with chronic lymphocytic leukemia (CLL). However, in routine practise, the majority of patients with lymphoproliferative disease are over the age of 70 years and most studies involving FCR have included younger, 'fitter' patients, on average in their 6th decade of life. It is not easy to extrapolate the results of these studies to routine practise. In general, the impression is that FCR is less well tolerated in the more elderly patients (>70 years) with good organ function. However, there is a relative paucity of evidence to support this. In this review we aim to critically examine the evidence of the efficacy and toxicity of FCR in the elderly patient.