Objective: To identify barriers and opportunities of an optimized treatment of depression in late life in Germany. Methods: Qualitative analysis of 12 expert interviews. Results: Experts recognized much room for improvement regarding late life depression care. A number of barriers were identified on the part of individuals affected, caring relatives and physicians and other therapists, as well as at the structural level. Lack of knowledge as well as a number of structural barriers result in diagnostic deficits and limited or inadequate treatment. The potential for improvement is explored. Conclusions: Parallel initiatives at different levels of care are suggested to optimize the treatment of depressed elderly people in Germany.