OBJECTIVES: Inappropriate polypharmacy is a particular concern in older people and is associated with negative health outcomes. Objective of this study was to identify potentially inappropriate medication (PIM) and major risk factors for hospitalization in elderly patients.  METHODS: It was an observational prospective study in semi government teaching hospital situated in south India (Karnataka). This study was performed for 3 month and data were collected from elderly patients having age above 60 year who were admitted to medical ward. RESULTS: Current analysis involving data of 150 (64 % male) elderly in patients with mean (SD) age of 67.9 (8.13) years. Majority of patients (30 %) were diagnosed with asthma followed by cancer (16 %). Mean (SD) hospital stay was 15 (5.23) days for cancer followed by 3 (0.77) days for asthma patients. Total 24 prescriptions were found with PIM as per beer’s criteria 2012. Out of which 50 % of the inappropriate medication found exclusively in asthma patients. Insulin was reported to be the single most PIM in 25 % of the prescriptions.  CONCLUSIONS: Asthma was found to be the single most common disease leads to hospitalization among elder patients. Cancer was found to be the single common disease which increases hospital stay. Group of patients with asthma were receiving highest numbers of inappropriate medication compare to other patients.