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Late\u2010onset Pompe disease is a multisystem condition, with a heterogeneous clinical presentation that mimics other neuromuscular disorders. <jats:italic>Methods<\/jats:italic>: Objective is to propose consensus\u2010based treatment and management recommendations for late\u2010onset Pompe disease. <jats:italic>Methods<\/jats:italic>: A systematic review of the literature by a panel of specialists with expertise in Pompe disease was undertaken. <jats:italic>Conclusions<\/jats:italic>: A multidisciplinary team should be involved to properly treat the pulmonary, neuromuscular, orthopedic, and gastrointestinal elements of late\u2010onset Pompe disease. Presymptomatic patients with subtle objective signs of Pompe disease (and patients symptomatic at diagnosis) should begin treatment with enzyme replacement therapy (ERT) immediately; presymptomatic patients without symptoms or signs should be observed without use of ERT. 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