Significant advances in rabbit medicine as well as improved knowledge in rabbit nutrition and husbandry have greatly extended the natural lifespan of many pet rabbits. It is no longer uncommon for exotic animal specialists to encounter pet rabbits with a reported age of 10, 12, or even more years. Neoplasia, cardiovascular, musculoskeletal, renal, and ophthalmic diseases are frequently reported in aging rabbits. Although not well described, cognitive decline may also occur. Older rabbits, as in geriatric dogs and cats, may also be affected by multiple chronic co-morbidities. A focus on maintaining a good quality of life is essential when caring for and treating this population. In addition to the effects on their nutritional, environmental, and care requirements at home, these chronic diseases can also negatively impact handling, anesthestic, and surgical risks in the hospital. Often a delicate balancing act is required to effectively manage multiple conditions, yet preserving the rabbit’s joie de vivre. Clear and open lines of communication between the veterinarian and the owner is essential to successfully support a rabbit navigating its later years. This should include frank discussions regarding death, as well as the criteria for and timing of euthanasia.