||The aging population is increasing worldwide. The decline in cognitive functions, health literacy, visual and hearing limitations add to the challenge of acquiring adequate knowledge. The level of Knowledge has been associated with overall health outcomes. This study aimed to address the Medication Knowledge (MK) in elders. Identify factors associated with knowledge and areas where the knowledge needs to be enhanced. The MK in elders was poor. Illiteracy, Polypharmacy and follow up in multiple clinics compromised knowledge. Knowledge with regards to side effects fared worse. Elders were most knowledgeable on how to store the medications and refills dates. Elders considered knowledge provided by medical staff about their medications as inadequate. The health care providers should be aware that a large gap in MK exists in elders. Multiple factors make MK enhancement in elders very challenging. Knowledge Improvement requires defining evidence based approaches and needs to be individualized. Prospective studies addressing the impact of interventions on improving knowledge and important outcomes like safety, adherence and mortality are needed.