This study aimed to investigate the prevalence of practical problems with medications use experienced by elderly patients and the management strategy employed to overcome the problems. This study also aimed to evaluate the belief and attitude of elderly patients toward deprescribing. Methods: A cross-sectional study was conducted among elderly patients that seeking treatment in a primary care clinic in Malaysia from September to November 2018 using a set of researcher-assisted and validated questionnaire on their consent. Findings: A total of 182 elderly patients were included in this study. A majority of participants (n = 87, 47.8%) admitted experiencing practical problems with their medication use. There are varieties of choice of management strategy employed by elderly patients to overcome the problems. For the willingness to deprescribing, there were positive correlation for patients' age (rs (182) =0.183, P < 0.05) and number of medications (rs (182) =0.271, P < 0.01) with the burden factor. There were also a negative correlation of age (rs (182) = −0.174, P < 0.05) and number of medication (rs (182) = −0.176, P < 0.04) with appropriateness of medications. Conclusion: A majority of Malaysian elderly experience practical problems with their medication use. Elderly patients' belief and attitudes toward deprescribing were influenced by age and number of medications.