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Background: Elderly patients with multimorbidity have a high prevalence of polypharmacy. Although negative consequences of polypharmacy have been reported, the definition of polypharmacy and inappropriate polypharmacy have not been established. The purpose of this study was to review the definition of polypharmacy and foreign countries’ interventions aimed at improving the appropriate use of polypharmacy in older people. We searched for relevant studies up to December 2024 using MEDLINE, Cochrane Library, and reports using Google. We also conducted web searches and literature reviews in Australia, the United Kingdom, and global organizations such as the World Health Organization (WHO). We found out that polypharmacy can refer to the prescribing of many drugs (appropriately) or too many drugs (inappropriately). Problematic polypharmacy was defined as ‘the prescribing of multiple [medicines] inappropriately, or where the intended benefit of the [medicines] is not realized’. Also, it is necessary to develop guidance on inappropriate polypharmacy and intervention to improve drug-related problems due to polypharmacy among the elderly.