Traditionally, the standard therapy for the management of acute myeloid leukemia (AML) in elderly patients has been low-dose cytarabine, but hypomethylating agents (HMAs) have quickly become the backbone of AML treatment in many countries. Here, Chrisoph Röllig, MD, from the University Hospital Carl Gustav Carus, Dresden, Germany, provides evidence for the efficacy of HMAs in the elderly and those with unfavorable cytogenetics, including an increased tolerability and decreased toxicity when compared to intensive chemotherapy. Early clinical trials into HMAs combined with other drugs, such as venetoclax, have demonstrated increased complete remission rates and prolonged survival in elderly AML patients. This interview was recorded at the 2018 European School of Hematology (ESH) Clinical Updates on Acute Leukemias, held in Budapest, Hungary.