The review highlights the significant disease burden of respiratory syncytial virus (RSV) in older adults (≥60 years) and discusses recent developments and challenges in RSV prevention. In industrialized countries, RSV incidence rates and hospitalization rates among older adults are estimated at 600.7 cases per 100,000 person-years and 157 hospitalizations per 100,000 person-years, respectively. However, accurate determination of RSV morbidity and mortality is challenging, leading to underestimation of the disease burden. In-hospital fatality rates vary with age and geography, reaching up to 9.1% in developing countries. Two promising RSV vaccines for the elderly have been approved, demonstrating efficacies of up to 94.1%, marking significant progress in prevention. However, concerns over potential side effects remain, and further studies are needed to assess real-world effectiveness and understand rare side effects. The review emphasizes the need for broad inclusivity in future trials to maximize the benefits of these vaccines.The review highlights the significant disease burden of respiratory syncytial virus (RSV) in older adults (≥60 years) and discusses recent developments and challenges in RSV prevention. In industrialized countries, RSV incidence rates and hospitalization rates among older adults are estimated at 600.7 cases per 100,000 person-years and 157 hospitalizations per 100,000 person-years, respectively. However, accurate determination of RSV morbidity and mortality is challenging, leading to underestimation of the disease burden. In-hospital fatality rates vary with age and geography, reaching up to 9.1% in developing countries. Two promising RSV vaccines for the elderly have been approved, demonstrating efficacies of up to 94.1%, marking significant progress in prevention. However, concerns over potential side effects remain, and further studies are needed to assess real-world effectiveness and understand rare side effects. The review emphasizes the need for broad inclusivity in future trials to maximize the benefits of these vaccines.