Background: the elderly are frequently exposed to drug-related problems and their consequences. Information relating to the appropriateness of the medication used by Romanian elderly is scarce. Objective: to identify the main potential inappropriate prescribing (PIP) instances in a sample of Romanian elderly nursing-home residents, concerning prevalence and subtypes. Methodology: the residents’ medical data were reviewed by a clinical pharmacist considering published geriatric pharmacotherapy recommendations, including four published PIP evaluation tools (the Beers criteria, STOPP-START tools, the PRISCUS list). Results: 91 residents were evaluated; mean age (mean ± SD) was 80.77 ± 6.82 (years), 28 (31%) were ≥85 years old and 58 (64%) had dementia. The median number of diagnoses was 6 (range 2 - 11) and the mean number (±SD) of daily medications was 8.26 (±3.52). An estimated mean (±SD) of 2 (±1.41) PIP per resident was identified, with 117 misuse-PIP (46.24%), 60 underuse-PIP (23.72%), 41 lack of monitoring-PIP (16.21%) and 35 overuse-PIP (13.83%). The most frequent PIP subtypes were the use of nonsteroidal anti-inflammatory drugs as chronic analgesic treatment in osteoarthritis (29.67%), underuse of fall prevention (100%) and analgesic therapies (23.08%), overuse of nootropic medications (26.98%) and lack of annual creatinine assessment (30.77%). Conclusion: a more geriatric-oriented care seemed to be necessary, but larger studies are needed to confirm these findings.