Elder maltreatment is pervasive throughout the WHO European Region: at least 4 million elderly people are estimated to experience maltreatment in any one year and 2500 of them will die each year. Most countries in the region have an ageing population, putting increasing numbers of people at risk.This report highlights the biological, social, cultural, economic and environmental factors that influence the risk of being a victim or perpetrator of elder maltreatment, as well as the protective factors that can help prevent it. There is some evidence of effective interventions, including psychological programs for perpetrators and programs designed to change attitudes towards older people, improve the mental health of caregivers and, in earlier life, to promote nurturing relationships and learn social skills. The evidence base needs to be strengthened, but surveys show that the public and policy-makers are already concerned about the problem. This report proposes a set of actions for Member States, international agencies, nongovernmental organizations, researchers, practitioners and other stakeholders to strengthen the policy response and devote adequate resources to the issue.