This chapter focuses on successful ageing in very old individuals, and provides a scope review on how the concept has been approached in centenarian studies. Using “successful ageing” AND “centenarians” in a search across PUBMED and ISI Web of Knowledge, 125 articles were identified. This analysis focused on a final set of 12 studies that have explicitly presented a successful ageing definition or appointed its potential components for this specific age group. Main findings demonstrate an emergent interest in understanding successful adaptations to extreme longevity within both well-established conceptual frameworks (e.g., Rowe and Kahn’s model) and through the development of comprehensive alternative models (e.g., Developmental Adaptation Model; Multidimensional models). Several studies, on the other hand, have tried to explore characteristics and factors associated with successful ageing that are not based in any defined model but rather in wide-ranging psychological constructs as resilience. Regardless of the used approach for defining and/or assessing “success” in centenarians, findings highlight its incontrovertible subjectivity (rather than objectively reaching the age of 100 as per se, like it is often appointed in several studies) and the need for studying more constructs that recognise the role of psychological aspects of adaptation to extreme longevity.