OBJECTIVES To identify cases of polypharmacy (PF) and to describe their social and clinical characteristics, satisfaction and costs in elderly patients who attended Family Medicine healthcare services at the Mexican Institute of Social Security (IMSS). METHODS Cross sectional study in 260 elders (°Y ́65 years old) who attended a Family Medicine facility at the IMSS in Mexico City. A survey and a concurrent review of medical records were performed to identify characteristics of drug prescription and patients’ satisfaction in the previous 3 months. The WHO definition of polypharmacy was used to classify this prescribing pattern simultaneously consumption of more than 3 drugs. Costs were estimated from an institutional perspective and are expressed in US dollars (USD). RESULTS Mean age was 71 years (6.9 SD), 60.8% were female, 15.8% illiterate, 53.5% married, 10.4% single and 35.4% widow/widower. A high percentage (86.2%) reported having a chronic disease; the main problems were hypertension (57.7%), diabetes (35.4%), and sleep problems (35.4%). Satisfaction with medication was very high 56.9%, high 28.5%, mild 8.1%, low 1.2%, and very low 0.8%. Drug mean cost per patient was 6.6 USD (per month) with a maximum of 61.8 USD. Prescription of 3 drugs at the same time was reported in 64.2% and polypharmacy in 49.2% CONCLUSION Our study found that polypharmacy was a common prescribing pattern in Family Medicine services. Prescription of 3 drugs at the same time and polypharmacy might lead to an important proportion of health care costs. Among the elderly population the proportion of chronic conditions was high, as was satisfaction with drug treatment. It is possible that there is a trade-off between improvement of symptoms and adverse side effects of drugs; therefore it would be necessary to research the quality of life, drug prescription and its justification in these patients.