The elderly represent a group at risk of receiving problematic benzodiazepine (BZD) prescriptions in terms of duration or dose. The objective of this article is to investigate the difficulties related to the initial prescription, renewal, and withdrawal of BZDs in two university hospitals in French-speaking Switzerland. Specifically, we studied the actual use and perceived usefulness of clinical guidelines, the assignment of responsibilities among prescribers, and the assessment of public health risks. Eight semi-structured interviews were conducted with professionals from different specialties. A lack of usable clinical recommendations was noted, attributable to the lack of scientific knowledge and the complexity of geriatric cases. The introduction and renewal of prescriptions should be the result of systematic consultations between hospitals and ambulatory care.