The study of autoimmune manifestations in the elderly should be considered a priority for future medical research because of increasing life expectation, especially in developed countries. Although autoimmune processes should not be considered an obvious characteristic of old age, a large proportion of elderly people may have positive autoantibodies. Few studies have focused on the clinical presentation of systemic autoimmune diseases in the elderly, which are characterized in most cases by atypical features, insidious presentation and a lower expression of immunological alterations. This review analyses the characteristics and clinical expression of two systemic autoimmune diseases (systemic lupus erythematosus and Sjögren’s syndrome) in elderly patients.