The purpose of this paper was to conduct a systematic review of the literature on violence and aggressive behavior by and towards older adults in the context of serious mental illness. Literature was identified via comprehensive searches of PsycInfo, MedLine, AgeLine, CINAHL, PubMed, Biomedical Reference Collection, Sociological Abstracts, and Google Scholar. Key findings of the review are as follows: (1) older adults with serious mental illness are at risk for violent and aggressive behavior; (2) there is limited research on aggressive behavior in older adults with serious mental illness who do not have comorbid dementia; and (3) older adults are at increasing risk of experiencing aggressive behaviors from their mentally ill adult children for whom they provide care. Limitations of the available literature reviewed include possible underreporting of violent and aggressive behavior, a lack of consensus regarding the age at which one is considered to be an older adult, and varying subjective experiences across participants regarding what constitutes violent and aggressive behavior. The literature reviewed suggests that preventing and managing aggression and violence by or towards older adults should emphasize a collaborative approach that integrates the social, interpersonal, situational, and cultural contexts both in future research and clinical practice.