Objective: As noted in previous reviews, the prevalence rates for somatoform disorders in the elderly that have been reported are highly heterogeneous. The main aim of this paper is to identify the reasons for the substantial variation in prevalence rates and discuss the potential of future diagnostic criteria to address current difficulties. Methods: We conducted a selective review of the literature on the prevalence of somatoform disorders in elderly populations. Results: We found significant conceptual differences between the described diagnostic groups and the criteria applied across studies. Moreover, substantial disparities related to sample selection, age cut-offs, and applied measures were revealed. Conclusions: A general conceptual confusion exists throughout the literature regarding somatoform disorders in the elderly that significantly hinder the comparison and integration of results and can lead to premature conclusions. The redefinition of the somatoform disorder category in the next version of the DSM should be taken as an opportunity to address this issue and facilitate research.