The decision to perform euthanasia in geriatric zoo mammals is usually a highly complex procedure involving ethical, medical, emotional and sometimes political factors. However, subsequent necropsies show that the pathological changes of organs and/or the musculoskeletal system are often already advanced. Therefore, we hypothesise that euthanasia is often delayed to the detriment of the animal's welfare. The purpose of this study was to facilitate and establish an initial, objective, decision-making framework for the euthanasia of geriatric zoo mammals. A scoring-system to assess the physical condition and quality of life in ageing zoo mammals is presented, based on retrospective and prospective investigation of 70 geriatric zoo mammals in five European zoos. Medical records and necropsy reports were studied in retrospective cases. Symptoms were monitored and recorded in prospective cases. Radiographic investigations under general anesthesia or at necropsy were performed additionally. A significant association between symptoms and pathological findings revealed that 36.9% (n = 24/65) of examined animals (n = 41/65) had pathological alterations to the musculoskeletal system and 26.2% (n = 17/65) suffered from neoplasia. Based on the individual reports, 28 veterinarians from different fields of veterinary medicine concluded that these animals had mild to severe pain, discomfort and a significantly reduced quality of life, thus strongly reducing welfare. The proposed scoring system includes all of these factors and offers a simple and reliable tool to support decision-making for euthanasia in geriatric zoo mammals.