The incidence of acute myeloblastic leukemia increases with age. The unfavorable biology of the disease, comorbidities, and significant side effects of the intensive treatment make treatment decisions difficult. New and less toxic targeted approaches are under investigations in this setting and the main problem remains to determine which strategy for patients over 65 years of age. Some of them will be treated successfully using intensive chemotherapy, while a majority of them will fail. Older patients are heterogeneous and enrolling them in investigational therapy is justified, according to proven methods to stratify them.