Abstract: The aging population is increasing globally, leading to a higher prevalence of elderly patients with multiple co-morbidities requiring hospitalization. Medical-surgical units often serve as primary care areas for such individuals, who present with complex medical, psychological, and social needs. The presence of multiple chronic diseases—such as diabetes, hypertension, cardiovascular disease, chronic kidney disease, and arthritis—creates unique challenges for nurses in managing care. These complexities are compounded by age-related physiological changes, polypharmacy, and increased risk of complications such as falls, infections, and pressure injuries. This article explores the essential aspects of nursing care for elderly patients with multiple co-morbidities in medical-surgical units. It emphasizes comprehensive assessment, individualized care planning, medication management, multidisciplinary collaboration, patient and family education, palliative care considerations, and strategies to prevent hospital readmissions. The role of nurses in providing holistic, evidence-based, and patient-centered care is highlighted, alongside implications for policy and future nursing practice.