The American Indian tribal nations and communities have long experienced health status worse than that of other Americans. Although major gains in reducing health disparities were made during the last half of the 20th century, most gains stopped by the mid-1980s. Consequently, health disparities continue to exist with marked variation across Indian Health Service (IHS) areas and within tribes. This is especially concerning for low-income, elderly members of the American Indian community. Addressing chronic diseases in elderly American Indian communities will help everyone reach the "Healthy People 2010: Understanding and Improving Heath" goals of improving the quality of life and increasing the life expectancy of American Indians. In an effort to reduce these existing health disparities, it is important to understand the major illnesses affecting the American Indian community and address mechanisms to address the illnesses within the American Indian community. This is a review of the literature about the major illnesses found among elderly American Indians living on or near a reservation. Four sources, including CINAHL, Google Scholar, MEDLINE, and PsycInfo, were used to review the literature regarding elderly American Indians living on or near a reservation for the three leading causes of death (heart disease, cancer, and diabetes) and suggested recommendations for health intervention programs in these disease areas. (Contains 2 tables and 53 notes.)