Introduction: Older adults are mostly prescribed with multiple medications due to their medical conditions,which contributes to the risk.Potentially Inappropriate Medication (PIM) and Polypharmacy are more predominant issue among elderly Patients. The main aim of this study was to interpret the Prescription Pattern Use and Polypharmacy above the age group of 65 using AGS 2019 Beer’s criteria. Methodology: This prospective observational study was conducted in tertiary care public hospital, in south India. About 80 In-patients aged >65 years admitted between the month of February-2023 to April-2023 were included, in which the Polypharmacy and prescription pattern use in geriatric patients were recorded. The 2019 AGS Beers criteria was applied to assess prescription patterns. Descriptive statistics was calculated as frequency percentile & Chi-square test were used to assess polypharmacy and prescription pattern. P-value < 0.05 was considered statistically significant. Polypharmacy was categorized as (No-polypharmacy, Polypharmacy, Hyper-polypharmacy) by evaluating the case report form. Results: Out of 80 patients, 55 (67.5%) are under PIM, and 25 (32.5%) are Non-PIM. The majority of the population was under polypharmacy & hyper-polypharmacy 63 (78.75%). PIM taken by the participants ranged between 1 to 3 medications. Proton pump inhibitors, tramadol & corticosteroids were the top 3 most frequently encountered PIMs. Hyperpolypharmacy and older age were identified as independent factors associated with PIM use. The risk of PIMs rises with the number of medications prescribed. Conclusion: The evidence presented indicates that the majority of the population was simultaneously prescribed PIM and polypharmacy, which can cause life-threatening adverse drug reactions and may reduce their life expectancy.The possibility of reducing PIM use in elderly patients may be achieved through various interventions such as medication reviews, patient and healthcare provider education, medication therapy monitoring, and deprescribing of unnecessary medications.