Volumetric neuroimaging studies of the elderly with affective disorders provide important insights into the underlying physiology of the illnesses. Advantages of studying the elderly include the ability to make various assessments and obtain a history differentiating subtypes of illness. However, challenges to studying the elderly include the heterogeneity of affective illnesses and confounds of medical comorbidity and medications. Volumetric assessments have provided important information in the neural mechanisms of mood regulation, especially in the overlap of cognitive disorders. This article reviews articles describing findings of volumetric analyses in elderly with unipolar depression and bipolar disorders, and compares and contrasts these findings with the larger volumetric research in affective disorders.