Introduction: Polypharmacy is sometimes necessary but should be carried out with precautions when prescribing to the elderly age group. It may cause drug-drug interactions which can be dangerous and may land up into life-threatening situations. Aim: To study polypharmacy and drug-drug interactions among diabetic patients of the elderly age group at rural tertiary care hospital. Methodology: It was a cross-sectional study carried out at Acharya Vinoba Bhave Rural Hosptial, Sawangi, Wardha. Data were collected from case sheets of patients (n = 100) of either sex admitted to the hospital during the two months of study duration. Result: Patients between the age group 60__ampersandsignndash;69 years were the most common (65%) followed by 70 -79 years (26%) and 80 -89 years (9%) admitted to the hospital. The average number of drugs prescribed to 60 - 69 years, 70 __ampersandsignndash; 79 years and 80 - 89 years age group were 4.85, 4.63 and 3.09 respectively. Total 402 drugs were prescribed in 100 patients and a total of 239 drug-drug interactions was observed in the current study. Conclusion: Polypharmacy is a double-edged sword. Benefit-risk assessment always should be done before prescribing mul tiple drugs to elderly patients.