Elder abuse is a significant public health problem in the United States. It affects millions each year and costs billions of dollars annually. Prevention and intervention of elder maltreatment requires a holistic approach that is interdisciplinary and incorporates a variety of diverse theoretical perspectives that fundamentally change how systems of elder care interact and operate. This chapter synthesizes the current knowledge on elder abuse and neglect. It begins by discussing some methodological limitations associated with defining and conceptualizing elder maltreatment along with its consequence for understanding the scope of the problem. It then discusses the individual-level risk and protective factors for elder abuse and neglect across a variety of institutional settings. Next, the risk and protective factors are situated in the context of sociological and criminological theories and a policy framework for elder abuse prevention and intervention based on current evidence-based practices is articulated. The chapter ends by discussing emergent directions that researchers, practitioners and stakeholders must address in order to ensure that our nation’s most vulnerable population is free from victimization in variegated settings.