Throughout many countries in the developed world, largely because of increasing life expectancy, the population is ageing. One of the economic implications of this demographic change is that workers may need to work longer and retire later than they have done in recent years. Much needs to be done to ensure that work remains a positive experience for workers throughout their career trajectories, and that it does not damage their health. The major contemporary challenges to health at work are those associated with the way work and work organizations are designed and managed. This is especially true for older workers. This paper focuses on the relationships between age and work performance, between age and work-related health, and between age and work-related stress. It concludes that there remains considerable scope for designing optimal work systems to harness the potential and protect the health of older workers. This important initiative will require a co-ordinated and multidisciplinary occupational health strategy.