This Study was performed to monitor adverse drug reaction in geriatric patients in Medicine ward of Rajah Muthiah Medical College and Hospital. Demographic analyses of prospective study revealed that out of 520 patients, 342 (65.76%) were males and 178 (34.23%) were females. Study reveals that 56.53% of geriatric patients were prescribed 6-8 drugs for their treatment. The patientshad developed ADRwithin the age range of 65 to 69 years (39.17%) followed by 60 to 64 years (29.89%) , 24 patients (24.74%) of age 70 to 74years and 6 patients above 75years. The majority of ADR was hypoglycemia followed by sedation, rash, hard stool and swelling at injection site. It is evident that Antimicrobial agents were mainly suspected followed by cardiovascular drugs, Endocrine acting drugs.The causality assessment of ADRs was performed using WHO –UMC scale illustrate that in greater part of the cases, a causality relationship belongs to the class of ‘probable’ 68 (70.10%) and ‘possible’ 27 (27.83%) while 2(2.06%) cases was found to be ‘certain’. After estimating the severity by Hart wig’s scale, out of 97 ADRs, 11(19.29%) were severe, 39 (68.42%) were moderately severe, while 7(12.28%) were mild in nature. The implementation of antibiotic guidelines in hospital setting and severe adherence to encourage the rational use. Clinical pharmacist responsible for identifying the ADR and educating the healthcare professionals regarding the need of reporting the occurrence could improve ADR.