Objectives: to assess pattern of symptomatic idiopathic OA in the elderly and the possible risk factors in that group of patients. Subjects and methods: A cross sectional study was conducted among 100 patients aged ≥ 60 years from Ain Shams University hospital, each patient was subjected to comprehensive geriatric assessment. Hip, hand, and knee OA were diagnosed by American College of Rheumatology criteria, and 1st metatarso-phalangeal , talonavicular, wrist joints, lumbar apophyseal joints and cervical apophyseal joints were diagnosed by presence of any of clinical manifestations plus Kellgren and Lawrence grading (≥ grade 2). Risk factors were reported by history, examination and occupational exposure questionnaire. Results: Knee, hip and hand OA were present in 80%, 23% and 30% consecutively. 38% were obese and 12% were smoker. Seventy one percent were at risk of carrying heavy objects. Females have significantly more knee, hand, wrist, cervical and foot OA than males. Females were more obese and less smoker (P= 0.002 and ˂0.001 consecutively). Conclusion: Females have overall and individualized sites (including: knee, hand, wrist, cervical and foot) OA more than males, and higher risk factors than males (including BMI and repeating the same movement in many sites).