Neurobehavioral symptoms are difficult to manage in dementia patients. Agitation may negatively impact patients’ health and increase the caregiver burden. Pharmacological and non-pharmacological approaches can be adopted to reduce agitation. Recently, positive effects of gabapentinoids have been identified in case reports with promising results and good safety profiles. This observational study was aimed to evaluate the effects of gabapentinoids (gabapentin and pregabalin) on agitation in patients with dementia and to document any adverse effects. This was an observational study consisting of ten patients (six female, four male). The mean age was 85.6years (range: 67–97). Eight of the patients (80%) were diagnosed with Alzheimer's disease, and two were diagnosed with mixed dementia. All patients were using acetylcholinesterase inhibitors and memantine either as a monotherapy or combined. No laboratory abnormalities were identified. The Modified Overt Aggression Scale was used to evaluate agitation. Each medication was started with a minimum dose at bedtime (100mg for gabapentin and 25mg for pregabalin) and gradually increased depending on its effect and adverse effects. The median dose was 366.7mg/d (range: 200–600) for gabapentin and 109.4mg/d (range: 25–300) for pregabalin. Agitation was taken under control within days in nine patients (90%) (three receiving gabapentin and six receiving pregabalin). Sedation was the only documented adverse effect in four patients (40%). One patient's medication was switched from pregabalin to gabapentin because of sedation and pregabalin was discontinued in another one due to inefficacy. Gabapentinoids are well tolerated in the elderly with promising results in agitated patients even at lower doses. Pregabalin could be a useful option in these patients.