Our aging populations have led to concern as to whether existing care provision will cope with the predicted future demand. The oldest old (those over 85 years) are a particular challenge; they are the fastest growing sector of our population and have high rates of comorbidity and cognitive impairment. Assistive technologies provide one possible solution to promote independence for older individuals, but are often underutilized in routine care. In this perspective, we consider how assistive technology can support the future care of the oldest old. First, we summarize the evidence on the health of the oldest old and their current use of assistive technology with a review on the evidence to date on the effectiveness, and potential benefits, of assistive technology. We then discuss the ethical issues associated with the use of assistive technology in this population and, finally, identify key directions for future research and service development in this field.