Balancing effective pain relief with patient safety in older surgical adults remains a significant clinical priority. Older patients are uniquely vulnerable to adverse drug effects and undermanaged pain can impair mobility, increase delirium risk, and prolong hospitalization. Excessive analgesia can precipitate respiratory depression, oversedation, and falls. This session will describe strategies that optimize postoperative pain management while minimizing harm, with attention to emerging non-opioid agents that may enhance multimodal therapy.