Platelets possess a dynamic functional repertoire that mediates hemostatic and inflammatory responses. Many of these functions are altered in older adults, promoting a pro-thrombotic and pro-inflammatory milieu and contributing to an increased risk of adverse clinical events. This review summarizes, drawing primarily from human studies, key aspects of aging-related changes in platelets. The relationship between altered platelet functions and thrombotic and inflammatory disorders in older adults is highlighted. Established and developing anti-platelet therapies for the treatment of thrombotic and inflammatory disorders are also discussed in light of these data.