The spinal stretch reflex consists of a relatively simple neuronal network. The Ia afferent fiber of the muscle spindle communicates to the alpha motoneuron via a single synapse. This basic pathway has been studied extensively over the past century, yet considerable information continues to emerge concerning the manner in which this pathway adapts to aging. It is well accepted that the amplitude of the spinal stretch reflex declines with normal aging, and it is intuitively agreed that these changes have a detrimental impact on the motor output of aging individuals. Understanding the changes observed in the spinal stretch reflex pathway due to aging requires a recognition of the changes that can occur in each component of this spinal network. This review will address these changes by following the spinal stretch reflex from initiation to completion. The components that result in the sensory input to the motoneuron will be covered first, followed by a review of the physiological changes that can occur to the motoneuron soma that can affect the processing of the sensory input. The output of the motoneuron encompasses the remaining components from the motor axon itself, to the neuromuscular junction, and then to the characteristic changes in the muscle. Finally, the functional effect that these changes have on the reflex as a fundamental motor behavior will be addressed, especially in terms of its impact on posture and balance.