In recent years, late-onset schizophrenia is a subject of controversial debate in the medical profession largely due to difficulties in reaching a consensus on the diagnosis of the disorder. In the present article we try to summarize in one place the scientific resources that were studying this disorder in the past decades and present a comprehensive overview from diagnosis to treatment of this relatively common disorder. Late-onset schizophrenia differs from early-onset schizophrenia in terms of symptoms, treatment, prognosis and pathogenesis, which is in early-onset schizophrenia based mainly on the developmental causes, whereas late-onset schizophrenia is most likely the result of a degenerative process within the central nervous system. Differential diagnosis of this disorder can be especially challenging and therefore demands additional attention. It is necessary to exclude degenerative diseases, expansive processes, neurological and psychiatric disorders, and ultimately, the abuse of psychoactive substances. Lately, there has been a lot of research done on genetic causes that could explain pathogenesis of the disorder, however, knowledge of the genetic influence for the establishment of clinical diagnosis is at this moment still inadequate. Thus, a clinical examination of the patient still remains the gold standard for the diagnosis of late-onset schizophrenia. Finally, we highlight the particularities of pharmacotherapy and summarize the current treatment guidelines for late-onset schizophrenia.