The population of elderly patients with von Willebrand Disease (VWD) is growing due to the improvement of medical care. The increase of co-morbidities and their treatment as well as standard preventive measures like anti-platelet or anticoagulation therapy constitute a challenge in the overall treatment of patients with coagulation disorders. Due to the lack of literature on older VWD patients, we discuss different aspects related to ageing in those patients. Plasma levels of von Willebrand factor (VWF) and factor VIII (FVIII), bleeding symptoms, treatment requirements and co-morbidities are possibly changing with age. Development of an evidence-based approach to the management of ageing VWD patients is therefore necessary.