Falls, gait disturbances, and balance disorders remain common problems for the elderly, all of which carry substantial public health implications. Few interventions, however, have been shown to reduce falls and injuries. Vitamin D replacement appears to be the most cost-effective intervention. Exercise and physical therapy have a modest benefit, with tai chi appearing to be most helpful for nonfrail elderly adults. The potential of using manipulation to prevent falls and improve gait and balance has not been adequately explored. The osteopathic medical profession can do much to cultivate this emerging area of clinical research by funding pilot and small research projects. Small basic science projects that explore plausible mechanisms and clinical trials that establish promising data are critical if this area of investigation is to mature. Given the high cost and morbidity associated with falls, gait disturbances, and balance disorders in the elderly, it seems reasonable that a treatment modality designed to improve musculoskeletal function is worth further investigation. This small but developing line of research relating to the potential benefits of OMT for managing falls, gait disturbances, and balance problems shows promise. This is an encouraging development, because a critical mass will be needed to determine if manipulative therapy can substantially reduce the occurrence of falls, gait disturbances, and balance problems for the elderly.